Orville Barrington Wright
Alabaster,AL
Summary
Dedicated Independent insurance ADJUSTER professional with diverse cross functional background coupled with an excellent record in investigating and processing insurance claims. Proficient in interpreting policies, negotiating settlements and takes pride in providing exemplary customer service. Strong command of claimant information intake processes, records documentation and fraudulent investigation protocols. Impactful skills preparing operational reports, presenting information to audiences and approving claim payouts.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Independent Adjuster
Pilot Catastrophe Services,
02.2016 - Current
- Review client claim submissions to ensure accuracy, confirm coverage per contract terms, and verify all required supporting documentation is received.
- Process and record claims in the claims management system.
- Conduct detailed claims analysis, including reconciliation of inception-to-date claim balances and tracking aggregate deductibles and/or reinstatement premium calculations as applicable.
- Generate reports and analyze data to effectively manage the claims portfolio.
- Collaborate with finance and accounting teams to support data-related needs,
- Supported claims adjusters in processing hundreds of first and third party commercial flood, and home owners insurance claims
- Developed strong understanding of insurance policies and legal issues through completion of series of INS classes coupled with in depth, multi week claims training.
- Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.
- Review client claim submissions to ensure accuracy, confirm coverage per contract terms, and verify all required supporting documentation is received.
Process and record claims in the claims management system.
Conduct detailed claims analysis, including reconciliation of inception-to-date claim balances and tracking aggregate deductibles and/or reinstatement premium calculations as applicable. - Documented information gathered in field and uploaded data to company database for efficient processing using Guidewire/Enterprise Claims System.
- Determined liability outlined in coverage and assessed documentation as such from police and healthcare providers to understand damages incurred.
- Maintained claims data in Company's systems.
- Ensured regulatory compliance in handling claims by adhering to state laws, insurance policies, and company guidelines.
- Directed claims negotiations within allowable limit of $100,000.00 and supported successful litigations for advanced issues.
- Reviewed auto/property claims file for correct estimate, coverage and claim file notes
- Relocating salvage timely and investigating salvage value to negotiate settlement
- Investigating coverage, cause, nature and extent of damage to assess loss value.
- Preparation of necessary correspondence to insureds, claimants, lien holders and legal representatives
Maintain effective diary and reserve. - Maintained superior quality rating of 94% in file handling and claims resolution, exceeding 85% departmental goal.
Identified suspicious claims, escalating issues to supervisor for further investigation and analysis. - Carried and managed consistently heavy project workload through exemplary organizational, time management and collaboration talents.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
- Issued payouts to claimants.
- Kept current on insurance regulations, laws, policies and procedures.
File/Property Claims Examiner
E. A RENFROE & COMPANY
04.2011 - Current
- Conduct detailed claims analysis, including reconciliation of inception-to-date claim balances and tracking aggregate deductibles and/or reinstatement premium calculations as applicable.
- Generate reports and analyze data to effectively manage the claims portfolio.
- Strong understanding of reinsurance contracts and the ability to apply contract terms and conditions to submitted losses.
Collaborate with finance and accounting teams to support data-related needs, - Reviewed auto/property claims file for correct estimate, coverage and claim file notes
- Prepared sketch of floor plan and roofline and entered data into estimating software to develop line-by-line item costs of damages
- Collaborated with contractors/insurance adjusters on property damage and compared cost estimates
- Carefully review captured photographs, and assess damaged vehicle/property
- Conduct evaluation of total losses and handle decision making in line with claims and local laws
- Professionally negotiate with repair service providers, customers, and vendors
- Investigated claims against insurance for personal, casualty, property loss and damages
- Received and acted on calls from creditors & policyholders, regarding claim status
- Prepared report of findings and negotiated settlement with claimant.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Directed and coordinated various investigations conducted by field investigation team.
- Directed and coordinated various investigations conducted by field investigation team.
- Managed high volume of cases simultaneously while maintaining accuracy and attention to detail throughout examination process.
- Substantiated legitimate claims.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Facilitated training sessions for new hires on proper claim handling techniques, contributing to increased efficiency within the team.
- Developed excellent rapport with policyholders by providing clear communication on claim progress and potential outcomes.
- Visited customer locations to evaluate damage and provided cost estimates for remediation.
- Reduced fraudulent claims activity by conducting in-depth investigations and collaborating with law enforcement agencies when necessary.
- Examined claims forms and other records to determine insurance coverage.
Contract Mediator
Florida Department Of Financial Services
01.2005 - 06.2011
- Drafted detailed legal documentation and meeting notes to support case files and move towards comprehensive conflict resolution.
- Devised and implemented dispute resolution processes for companies, enabling fast resolution of disputes.
- Resolved conflicts by applying mediation techniques and fostering open communication between disputing parties.
- Applied deep understanding of relevant laws and policies to reach agreements.
- Maintained up-to-date knowledge of industry trends, laws affecting mediation practice, and professional ethics standards through continual professional development activities.
- Created safe and neutral environment for parties to openly discuss their concerns, promoting constructive dialogue.
Education
Master of Science - Business Administration
Columbia Southern University
Orange Beach, AL10.2001
Bachelor of Science - Business Administration
Columbia Southern University
Orange Beach, AL12.1999
Skills
- Claims Handling and Investigations
- Processing Reinsurance Claims
- Claims report and Handling
- Policy Interpretation and Evaluation of Liability Exposure
- Insurance policy coverage knowledge
- Claims Evaluation
- Litigation Management
- Policy Interpretation
- Liability Analysis
- Settlement Negotiation
- Critical Thinking
- Coverage Determination
Certification
- Training in Basic and Advanced Mediation and Arbitration Certification from FINRA and the USPS REDRESS Program.
- Licensed as an Independent Adjuster in AL, WV, TX, SC MTR VEH Appraiser, SC, OK, NC, MS, MN, MI, LA, KY, IN, GA, FL, CA, and AR.
Skills Additional
- Able to use Microsoft Windows computers including Excel, Word, Access, Outlook.
- State Farm Enterprise Claims System, Mitchell, and Audatex
Timeline
Independent Adjuster
Pilot Catastrophe Services,
02.2016 - Current
File/Property Claims Examiner
E. A RENFROE & COMPANY
04.2011 - Current
Contract Mediator
Florida Department Of Financial Services
01.2005 - 06.2011
Master of Science - Business Administration
Columbia Southern University
Bachelor of Science - Business Administration
Columbia Southern University
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