Navy Bernard

Accomplished Senior Insurance Claims Adjuster with a track record of enhancing operational efficiency and driving effective resolution strategies, leveraging deep expertise in compliance and claims management.

• Global Risk Solutions (Erie Insurance), WFH-Remote, 04/2025, 08/2025, Senior Property Insurance Claims Adjuster, Conducts investigations, interviews, and inspects damage, based on the Field Adjuster's general reports when completed., Managed a portfolio of over 1000+ Property Claims with Erie Insurance in Residential and Commercial multiple states, IA, PA, WI & KY., Prepared estimates, made recommendations, handled coverage questions, and settled settlements., Sets and maintains reserves, reviews reports and related materials, directs experts, and determines coverage and claim value, and issues or declines payment., Interacts with Agents and district sales managers on matters of mutual concern., Completed industry-related training programs and continues to attend training programs to remain informed on policy changes and interpretation., Documented claim files and submitted a report for closure after payments have been approved and issued., Facilitated appeals of denial claims containing denials, errors, and issues with lack of authorization., Compile client data with discretion and formulate details reports to meet weekly reports.
• Catastrophe Response Unit Inc (CRU), WFH-Remote, 07/2024, 11/2024, Auto Total Loss (Alberta, Canada), Managed a portfolio of over 500+ auto total loss claims monthly, ensuring timely and accurate settlements., Conducted thorough investigations of claims, including interviewing claimants, reviewing documentation, and analyzing vehicle damage., Negotiated settlements with claimants, attorneys, and other stakeholders, achieving favorable outcomes for the company., Identified and resolved coverage issues, ensuring accurate claim settlements., Recognizing situations where fraud may be involved or where another party may be responsible for the loss., Working with repair shops, salvage yards, and other internal teams to facilitate the claims process., Reviewing accident reports, police reports, and other relevant documentation to determine the cause and extent of the damage.
• Global Risk Solutions (Erie Insurance), WFH-Remote, 03/2023, 02/2024, Senior Property Insurance Claims Adjuster, Managed a portfolio of over 1000+ Property Claims with Erie Insurance in Residential and Commercial for the State of Kentucky., Investigated losses and determined coverage for facts of loss with wind and hail, water damage, fire, and catastrophic events., Evaluated the extent of company liability during investigations with evidence, reports, and records., Reviewed and set reserves for all coverages involved., Evaluated policies and contract language to identify coverage issues., Settled claims, decreased claims payouts, and researched to gather information if necessary., Collaborated with upper management, consolidated with local agents and contractors for any discrepancies in estimates., Facilitated appeals of denial claims containing denials, errors, and issues with lack of authorization., Compile client data with discretion and formulate details reports to meet weekly reports., Supported management and direction of assigned complex claims for settlements., Helped to train new adjusters with company guidelines, regulations, and different strategies.
• MidAmerica Claims (Olympus Insurance Claims), 10/2022, 01/2023, Senior Property Insurance Claims, Identified insurance coverage limitations with thorough examinations of claims documentation and related records., Conducted thorough property investigations to identify and classify damages for customer claims., Collected and tracked evidence in support of legal processes., Reviewed and analyzed suspicious and potentially fraudulent insurance claims., Followed up with insured individuals regarding premium and deductible payments., Examined claims forms and other records to determine insurance coverage., Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors., Resolved complex, severe exposure claims using high service-oriented file handling., Negotiated and executed payout settlement agreements to resolve open claims., Helped train on new adjusters on claims systems and multiple claims-disputed calls.
• Crawford (Geico, Infinity & Kemper Autos), WFH-Remote, 02/2022, 08/2022, Subrogation Auto Investigator, Implemented improvements in manual and electronic billing procedures., Collected and tracked evidence in support of legal processes., Synthesized data into comprehensive quarterly written reports for management., Worked with attorneys and internal or external claimants to resolve claims., Evaluated cases for the final course of action based on the facts of the loss., Collected back deductibles and out-of-pocket expenses from at-fault carriers., Located adverse parties via the skip tracing system, crash auto systems., Documented claim accordingly and completed proper Subrogation demand letters to the adverse parties., Discussed liability with claimant carriers and negotiated final settlements., Identified insurance coverage limitations with thorough examinations of claims documentation and related records., Evaluated original investigation reports and documents to resolve secondary concerns., Conducted full claim investigations and reported updates and legal actions., Escalated files with significant indemnity exposure to the supervisor for further investigation., Conducted interviews with comprehensive interviews with witnesses and claimants to gather facts and information., Collected evidence to support contested claims in court., Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability., Documented claim accordingly and completed proper Subrogation demand letters to the adverse parties., Discussed liability with claimant carriers and negotiated final settlements through outbound and inbound calls with updated data on recoveries.
• MidAmerica Claims (Fed Net), 07/2021, 02/2022, Property Insurance Adjuster, Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability., Collected and tracked evidence in support of legal processes., Conducted thorough property investigations to identify and classify damages for customer claims., I interviewed agents and claimants to correct errors or omissions and investigate questionable claims., Identified insurance coverage limitations with thorough examinations of claims documentation and related records., Evaluated original investigation reports and documents to resolve secondary concerns., Followed up with insured individuals regarding premium and deductible payments., Investigated claims involving potential and suspected fraudulent activities., Maintained contact with claimants and attorneys to determine treatment status., Prepared summaries of damage, payments, and policy coverage.
• Allied Trust Claims, WFH-Remote, 12/2020, 07/2021, Independent Property Claims Adjuster, Investigated claims by reviewing policy contracts to determine claim coverage based on the cause and facts of the loss., Carefully reviewed claim information to verify accuracy and avert fraudulent claims., Reviewed and analyzed suspicious and potentially fraudulent insurance claims., Gathered and reviewed evidence such as police reports, property damage photos, and other relevant documents., Identified insurance coverage limitations with thorough examinations of claims documentation and related records., Evaluated original investigation reports and documents to resolve secondary concerns., Conducted thorough property investigations to identify and classify damages for customer claims., Analyzed information gathered by the investigation and reported findings and recommendations., Clarified coverage of losses to policyholders and assisted in itemizing damages and finding alternative living arrangements., Investigated and assessed property damage and reviewed property damage estimates., Collaborated with contractors, technicians, and vendors on complex losses to come to an equitable and accurate., Investigated, determined coverage on, and settled personal lines property claims under state and federal Insurance regulations.
• Global Risk Solutions, TPC Environmental, 11/2019, 08/2020, Supervisor, Team Lead Environmental Claims, Supervised a team of 40 Environmental Insurance Adjusters in a fast-paced, collaborative environment., Conducted regular team meetings to discuss goals and progress updates., Trained new team members on company policies and procedures thoroughly., Evaluated team performance and provided feedback for improvement continuously., Implemented new strategies to enhance productivity and customer satisfaction consistently., Oversaw claim processing and ensured compliance with company standards diligently., Resolved escalated customer issues and provided satisfactory solutions promptly., Approved claim payments and settlements based on information collected from customers and contractors., Explained coverage of the loss and assisted policyholders with itemization of damages, emergency repairs, and additional living arrangements., Quality control incoming property settlements, investigates, determines coverage of loss, and adjusts all elements of routine Property Loss claims., Investigated property lien, the release of liens, warranty deeds, affidavit of no lien, and affidavit of no insurance., Investigated TPC property damages, property settlements, and certification of self-repairs., Assigned workloads, maintained performance management, and reviewed daily activity reports., Evaluated employee performance and recommended promotions, transfers, and dismissals., Carried out day-to-day duties accurately and efficiently, and offered friendly and efficient service to customers, handling challenging situations with ease., Monitored priorities and liaised between the property team and management, delegating tasks to be completed on time.
• Worley Claims Services LLC., 08/2018, 10/2019, Environmental Subrogation Property, Evaluated original investigation reports and documents to resolve secondary concerns., Reviewed new claims to determine the status of subrogation potential and to develop a plan of action. adjuster's reports and estimates for accuracy., Investigated and settled complex environmental subrogation claims with estimated large losses., Responsible for the fair and accurate disposition of complex homeowner property claims by determining coverage, applying policy terms and conditions, determining damages, and negotiating settlements., Evaluated all evidence to create positive outcomes for our client's claims., Evaluated insurance policies and analyzed damages to determine coverage as it pertained to subrogation., Reviewed and analyzed suspicious and potentially fraudulent insurance claims., Negotiates and settles adverse subrogation and issues settlement checks and payments., Prepared subrogation demand packages and restitution proposals., Established productive working relationships with attorneys, property, and field adjusters., Determined liability outlined in coverage and assessed documentation, such as from police and healthcare providers, to understand damages incurred., Prepared settlement letters, denial letters, Reservation of Rights, and other letters needed., Settlements and concise diary notes, uses the Special Handling area, sets field assignments, sets, and saves contacts, and makes payments., Recognizes the need for SIU involvement and identifies files for potential subrogation., Appropriately applies knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations, and guidelines., Determines whether a file has a valid Assignment of Benefits and handles it accordingly., Effectively handles difficult calls from customers, attorneys, public adjusters, vendors, and others and sets up mediation or appraisal when needed., Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
• USAA, San Antonio, TX, 06/2016, 07/2018, Property Claims Examiner, Examined claims forms and other records to determine insurance coverage., I interviewed agents and claimants to correct errors or omissions and investigate questionable claims., Maintained a suspicious claims database and prepared reports for supervisors., Analyze claims to determine the extent of the company's liability and make approval or denial decisions., Handled and negotiated settlements with claimants under policy provisions., Collaborate with insurance agents and interview claimants to correct errors, rectify omissions, and investigate questionable issues., Prepared summaries of damage, payments, and policy coverage., Placing outbound calls to claimants and gathering more information on Peril's determination., Reviewed HO3, HO6, HO5, and DP3 Declaration coverages., Evaluated evidence to create positive outcomes for clients' claims., Collaborated with the claims department and industry anti-fraud organizations to resolve claims., Evaluated insurance policies and analyzed damages to determine coverage., Analyzed information gathered by investigations to report findings and recommendations., Investigated and assessed property damage and reviewed property damage estimates., Reviewed field inspections and coordinated all insurance claim audits.
• USAA, San Antonio, TX, 06/2014, 07/2016, Mortgage Fraud Compliance Analyst, Managed VA, Fannie Mae, FHA, and Conventional loan files for completeness and accuracy, and compliance through the Salesforce system., Managed mortgage applications, credit history, and income documents, and title documents., Assessed compliance with HMDA, CRA, RESPA, GFE, TILA, ECOA, FACTA, and state regulations., Reviewed and evaluated borrower (s) profile, including but not limited to all income documents and tax returns., Maintain preliminary reports, judgments. bankruptcy, and appraisals with A completed statement of credit denial notices and withdrawn loans., Identified portfolio risks resulting from the client's underlying business practices, underwriting. and/or fraud exposure., Evaluated debt ratio, loan-to-value ratios, credit score, property valuation, and various other factors., Audited and initiated underwriting for quality and ensured compliance, accuracy, and completeness of loans per guidelines., Performed accurate review of real estate loans using specific guidelines to determine whether a loan was underwritten under the underwriting guidelines., Performed Adverse Action reviews of applications an ease, before the closing loan., Scrubbed, Audited EHMDA LAR, updating with findings., Worked within applicable standards, policies, and regulatory guidelines to promote a safe working environment., Completed paperwork, recognizing discrepancies, and promptly addressing them for resolution., Prepared a variety of different written communications, reports, and documents., Created spreadsheets using Microsoft Excel for daily, weekly, and monthly reporting.

• Xactimate
• Guidewire
• Claim Center
• Claims Connect
• One System
• Estimatics
• XactAnalysis
• Symbility
• Pulse
• Diamond
• CCC
• Critics
• ASI
• Citrix