6-20 ALL LINES ADJUSTER
Licensing States: Florida, Texas, Georgia, Alabama, Montana, Michigan, Mississippi, Louisiana, N. Carolina, S, Carolina Indiana, Nevada, Oklahoma, Kentucky, Minnesota, and Canada Certification
*Handled late reported hurricane Irma claims as they approached and surpassed the Florida statue of limitations *prepared civil remedy notice Response letters and discussed with in-house counsel means of resolution. *Attended Mediation with the Opposing Counsel, the mediator, and the named Insured to discuss confidential negotiations in hopes of reaching an amicable settlement. *Received appraisal demands, assigned appraisers as well as established declaration of appraisal. *Received Final award packets which included signatures for appraisers and the appointed umpire; as well as tendered the final award payment *Complex Claim Handling *Large Loss Handling *Daily & Catastrophe handling, including but not limited to; water, fire, wind, hail, and theft losses *Assigned and Executed Examinations under Oath *Engaged in negotiations with the opposing counsel to reach compromised settlement agreements * Reviewed Structural and Forensic Engineer reports for coverage determination/causation *Scheduled and Conducted recorded statements *Reviewed and paid AOB's Mold remediation,water mitigation and tarp invoices according to industry standards *handled sewer back-up/ sump pump endorsements, special limits, as well as other specialty exclusions
*1st Party Litigation Claim handling. * Participated in over 100 triggered calls with House Counsel, management, and Defense Counsel to develop the best defense strategy * Reviewed compliance standards and due dates to assist the company in meeting its state authorized goals. * Organized matters from the commencement of the proceedings to the discovery period, through trial, post-trial, settlement, and appeals. * Handled daily residential, commercial, tenant, and condo policies that were damaged by covered perils. * Participated in meditation, and depositions during arbitration hearings. * Established reserve requirements, adjusting reserves, as necessary, during the processing of the claim. * Worked closely with counsel, attends mediation, arbitration, settlement conference, trial, and depositions.
*Reviewed, negotiated and settled the Assignment of Benefits directly linked but not limited to water mitigation, mold
remediation and contractor work orders. *Created and received appraisal demands as well as establish the declaration of
appraisal. *Reconciled estimates with contractors, Public Adjusters and Attorneys and all applicable legally represented
claims *Reviewed and settled award estimates, Created award packets as well as obtained final award signatures during
the pre-litigation process. * Invoked appraisal and assigned Non conflicting umpires. *Xactimate Collaboration. *Prepped
and assigned litigation. *Opened applicable exposures, set appraisal matters, and modified reserves accordingly
*Analyzing coverage, endorsements and exclusions applicable to HO3 ISO Policy, HO6, DP3, and DPM
Reviewed and Closed over 1000+ claims associated with damages caused by HURRICANE IRMA *Reviewed Supplemental Damages, Negotiating and Settling Residential and Semi-Large Loss claims. *Examining Property Damage via Xactimate, Macro assistance and Collaboration. *MCM and Claimscenter efficiency. *Global Policy Search Efficiency *Mediated Handling thru the complaints, litigation and resolutions unit. *Identified Policies that are not currently in force, and Assumed Policies * Determined policy endorsements and exclusions. *Qualified and Reassigned Claims where Appraisal, Disputes and water mitigation was applicable. *Negotiate Estimates and Invoices with assigned representatives in order to resolve disputed claimed damages. *Settled and Issued Payments within policy limits. *Set reserve and exposure limits *Reviewed Public Adjuster, Attorney, and LOR estimates including mold, and water mitigation invoices and AOB contracts. *Comprised Litigation and Mediation Letters and Correspondence and advised of subrogation proceedings.
*Reviewed Residential Property/Auto Claims for property with damages caused by HURRICANE HARVEY. *Reviewed, Examined and determined Total Loss eligibility. *Total Loss Handling *Assessed Subrogation Damages and reimbursement eligibility within policy limits *Field Inspections, and detailed comprehensive reports *Loss Of Wages *Additional Living Expenses * Q & A and file reviewing *FNOL *Reviewed claims for accuracy with field adjusters to make sure claims were being processed accurately. *Reviewed Contractor and Repair Supplemental damages and issued payment accordingly. * Conducted Interviews, gathered detailed information and completed file investigations. Identified and collected evidence and determined its value to a specific claim. * Explained premiums owed to policy holders, agents, and underwriting
*Handled a pending of over 100 claims involved in litigation, arbitration, or mediation counsel. *Work with Defense Counsel to set up low settlement opportunities or PFS settlements. *1st Party Florida Litigation. *Worked in tandem with Defense Counsel to develop No Peril Created Opening Induced Motion for Summary Judgement. *Participated in meditation, and depositions during arbitration hearings. *Reviewed compliance standards and due dates to assist the company in meeting its state authorized goals. *Participate in over 100 triggered calls with House Counsel, management, and Defense Counsel to develop the best defense strategy. *Presented over 300 files at panel conferences to determine proper litigation strategy. *Organize matters from the commencement of the proceedings to the discovery period, through trial, post-trial, settlement, and appeals. *Handled daily residential, commercial, tenant, and condo policies that were damaged by covered perils.
*Managed tasks and initial examing operations to assign to the litigation adjuster. *Communicated via telephone, email and fax with independent adjusters, public adjusters, attorneys, contractors and water mitigation companies regarding efficient claim handling. *Negotiated some settlements with the named insured and/or their representatives within policy limits. *Reviewing claims in detail to assist in sorting to appropriate litigation team.
Investigated red flags for fraud,embezzlement, money laundering tax evasion false accounting statements, organized crime. Managed accounting operations. Account reporting and reconciliations. Performed debit, credit, and total accounts on computer spreadsheets/databases using specialized accounting software. Prepared financial and regulatory reports required by laws, regulations or boards of directors
*Handled over 4000+ claims to resolution * Initiated first contact * Reviewed estimates and npublic adjuster demands * Negotiating Appraisal and selecting appraisers *Property/Auto Desk adjuster *Property/Auto Field Adjuster *State Farm Fire and property certification *Examined properties with damages caused by wind and hail damage. *Resolutions team *Total Loss and Liability Handling *appraisal reports, actual cash value, Depreciation, and Subrogation reimbursements and payouts *Age/Brittle test Slope Determination *Supplemental Damages *Original Estimate reviews and issuing payments attached to the mortgagee. *AWC *Daily Claims * Claim settling and subrogation. * Reviewed salvage and issued payments to insureds contractors, attorneys and public adjusters.
Xactimate, Xactanalysis, Guidewire, ECS, Claims source, Claims Center
Claims Xperience, AS400/ AS400 ImageRight, CCC-1, CCC Pathways
Flood Connect, ISO, Lexis Nexus, Mitchell, Audatex, Nextgen, Family General Insurance, Allstate General, People's Trust, Homesite, TWIA, Citizens Of Florida/ Louisiana, USAA, Tower Hill, NFIP,