Mary Estimbo
HOUSTON,TX
Summary
Motivated and highly adaptable casualty and property insurance professional with versatile experience in personal and commercial. Gifted in identifying and resolving problems. Expertise in policy interpretation, coverage determination and handling recorded statements. Adept at evaluating bodily injury claims and negotiating settlements. Outstanding customer service and personal service proficiencies. Motivated and highly adaptable casualty and property insurance professional with versatile
experience in personal and commercial. Dedicated team leader and contract negotiator that
provides excellent customer service by forming lasting relationships with clients while mitigating
risk for sales retention. A dynamic insurance professional seeking to leverage background into an
account management position with a progressive organization striving to increase and retain
customers while providing exceptional customer service.
Overview
30
30
years of professional experience
Work History
Executive Specialist, Senior Specialist
Crum & Forster,
12.2016 - Current
- Handle commercial auto liability and general liability bodily injury claims.
- Monitored auto repair process for best outcome for insured and claimant to minimize loss of use and down time costs
- Conducted investigations into coverage and liability, which required contact with witnesses, claimants, attorneys, and other third parties. Utilized and reviewed state laws and regulations
- Prepare disclaimers, and reservation of rights letters
- Negotiated claims to resolution with attorneys and claimants
- Direct attorney activities for litigated files
- Negotiated medical bills, Issue payments, and secure releases.
- Followed company policies and procedures to deliver quality work.
- Examined claims forms and other records to determine insurance coverage.
- Answered customer questions regarding deductibles.
- Investigated and reviewed property damage estimates
- Assisted colleagues in resolving complex coverage issues or difficult negotiations, fostering a supportive work environment that promoted teamwork and knowledge sharing. Trained colleagues on appropriate handling of Non Trucking Liability and physical damage claims
- Developed positive relationships with medical providers and repair facilities to facilitate efficient communication during claims process.
- Utilize fax, phone, texting, and email to secure necessary information to move claim to resolution
Field Adjuster
The General
05.2016 - 12.2016
- Handle auto damage and bodily injury claims both first party and third party claims
- Prepared property damage estimates
- Conducted investigations into coverage and liability which required in-person or over the phone contact with witnesses, claimants, attorneys
- Prepare reservations of rights and coverage denial letters
- Negotiated claims to resolution with attorneys and claimants
- Negotiated medical bills
- Issue payments.
Litigation Specialist
Allstate
02.2015 - 04.2016
- Handled litigated injury claims involving complex coverage and liability issues
- Take recorded statements, investigate scenes, review police report and determine liability
- Examined and reviewed information to determine if appropriate coverage is applicable to facts of loss; Evaluated bodily injury claims by reviewing medical records, medical bills, facts provided during discovery phase
- Developed defense strategy with house counsel, outside counsel, and management to handle litigated cases
- Conducted thorough investigations of claims, gathering critical evidence to support case resolution.
- Negotiated settlements in mediation and arbitration settings, resulting in reduced litigation costs for clients.
- Managed case load of up to 80.
Casualty Specialist-Litigation
Progressive
05.2006 - 07.2013
- Resolved pre-litigated and litigated injury claims, involving complex coverage and liability issue.
- Handled first party, third party, UM/UIM, and wrongful death claims and physical damage and property damage disputes
- Top closure status during tenure
- Communicated with medical providers and attorneys to evaluate appropriate treatment
- Reviewed medical records to identify, and address potential fraudulent activity
- Evaluated claim on basis of injury, treatment, and liability exposure
- Negotiated face-to-face resolution of high exposure loss claims, and secured proper legal releases
- Maintained proper reserves on claims
- Negotiated bills with third parties such as worker’s compensation carriers and medical providers
- Handled Arbitration filings for disputed cases
- Successful resolution on arbitration filings.
- Created customized action plans for each case according to its unique circumstances ensuring personalized attention while maintaining efficiency.
- Kept up-to-date with industry regulations and guidelines to ensure compliance in all aspects of claims handling.
- Managed caseload from 80-120.
Litigation Specialist
Progressive
09.2004 - 05.2006
- Investigated, analyzed, and determined the extent of liability concerning personal, casualty, or property loss or damages including first party, third party, UM/UIM, and wrongful death claims
- Attempted to effect settlement/resolution with claimants and attorneys on complex and serious injury claims
- Corresponded with or interviewed medical specialists, agents, witnesses, or claimants to compile information for use in liability determination and claim resolution
- Directed legal counsel in appropriate handling of litigated claim
- Negotiated worker’s compensation liens.
- Conducted thorough investigations of claims, gathering critical evidence to support case resolution.
Sr. Claim Rep-Certified
Progressive
04.2003 - 09.2004
- Handled auto damage and bodily injury claims both first party and third party claims
- Prepared property damage estimates
- Conducted investigations into coverage and liability which required in-person or over the phone contact with witnesses, claimants, attorneys
- Prepared reservations of rights and coverage denial letters
- Negotiated claims to resolution with attorneys.
- Apply state laws, tort concepts, and review any contracts
- Utilized contracts to mitigate loss, and apply risk transfer
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Self-motivated, with a strong sense of personal responsibility.
Unit Manager -Claim Reporting Center (CRC)
Travelers
08.2001 - 04.2003
- Managed, motivated and coached a team of eighteen employees to accomplish goals while providing exceptional customer service
- Utilized technical expertise to properly establish claims
- Identified potential candidates for career growth
- Ensured policy and procedures were followed in the establishment of new claims
- Monitored attendance, employee efficiency, productivity and established performance improvement plans for team members.
Workers Compensation Specialist
Travelers
01.1999 - 08.2001
- Specialized in investigation of work related injuries for large market accounts
- Work entailed accident investigation, and compensability determination
- Applied the Texas Workers Compensation Statute
- Timely filed state disputes
- Secured additional documentation such as medical records to substantiate position
- Communicated with defense counsel in regards to Benefit Review Conferences, Contested Case Hearings, and Appeals Panel submissions.
Claim Representative, Sr. Claim Representative, Technical Specialist
Travelers Property Casualty
07.1994 - 01.1999
- Specialized in commercial accounts
- Work entailed investigation, liability determination, and resolution of high value litigated and non-litigated commercial claims
- Applied tort concepts, legal liabilities defenses, contract law, agency relationships, and related compensatory damages
- Determined coverage based on insurance policies, evaluations of contracts between concerned parties, as well as laws and regulations
- Prepared coverage denial letters and reservation of rights letters
- Negotiated and mediated claims for the best possible outcome based on investigation, laws, and cost benefit analysis
- Maintained excellent rapport with client contacts, risk managers, policyholders, third party claimants and agents.
Education
BBA - Accounting
University of Houston
Houston, TXSkills
- Computer literate
- MS Excel,Word
- Active listening skills
- Utilize search engines to secure information
Additional Information
Texas Department of Insurance-Adjuster- All Lines License
Licensed in CT, DE, FL, KY, LA, NC, NH, NM, OK RI, SC, VT, WV, WY
Timeline
Executive Specialist, Senior Specialist
Crum & Forster,
12.2016 - Current
Field Adjuster
The General
05.2016 - 12.2016
Litigation Specialist
Allstate
02.2015 - 04.2016
Casualty Specialist-Litigation
Progressive
05.2006 - 07.2013
Litigation Specialist
Progressive
09.2004 - 05.2006
Sr. Claim Rep-Certified
Progressive
04.2003 - 09.2004
Unit Manager -Claim Reporting Center (CRC)
Travelers
08.2001 - 04.2003
Workers Compensation Specialist
Travelers
01.1999 - 08.2001
Claim Representative, Sr. Claim Representative, Technical Specialist
Travelers Property Casualty
07.1994 - 01.1999
BBA - Accounting
University of Houston
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