Sandra L. Upshur
Eight Mile,AL
Summary
Energetic and enthusiastic Claims Adjuster with 5 years of experience in investigating and analyzing personal, casualty and property loss. Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and dependable. Comprehensive knowledge of claims adjustments with special knowledge of Xactimate.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Residential-Desk Adjuster
Mid America Catastrophe Services
09.2022 - 10.2023
- Verify facts of loss and pertinent information to analyze and confirm coverage for both carriers Slide Insurance and Frontline Insurance
- Handle the adjusting of the entire claim, including collecting and reviewing all loss related facts, performing an analysis under the terms of the insurance policy to make coverage recommendation and issue payments within applicable authority level
- Determine the method and extent of investigation for each claim. Make assignment to outside experts or investigators when appropriate
- Handled large loss, public adjuster and attorney represented claims from Hurricane Ian and Nicole.
- Review and analyze all investigative and claim material to determine the facts of the loss, in a timely manner.
- Document all claim actions, inclusive of coverage and damage investigations, contacts, phone calls, emails, and correspondences in the claim file.
- Timely submit reserve and payment approval requests, as appropriate.
- Examined claims forms and other records to determine insurance coverage.
- Employed Xactimate, XactAnalysis, and Guidewire to complete claims.
Residential-Claims Adjuster
Mid America Catastrophe Services
09.2021 - 04.2022
- Addressed claims for the carrier Lighthouse Insurance as a desk adjuster
- Investigated claims to determine the cause of loss from the field adjuster general loss report, and photos
- Establish ultimate reserves (anticipated cost to bring file to closure based on known facts) as soon as practical and monitor to adjust at the time of any exposure changing event.
- Identify claims requiring a Reservation of Rights or denial, draft appropriate coverage correspondence and refer for management approval.
- Managed catastrophic loss events effectively by coordinating rapid response efforts and providing support to impacted policyholders.
- Estimated and made payments towards claim settlement
- Paid all invoices and all supplements for assigned claims
- Employed Next-Gen to complete claims.
Residential-Claims Adjuster
One Call Claims
10.2020 - 08.2021
- Addressed claims for FedNet Insurance as a desk adjuster
- Processed initial and supplemental claims
- Understanding of policies: state certifications
- Assessing damage
- Documenting all activities associated with a claim
- Providing excellent customer service through the entire claims process.
Residential-Claims Adjuster
Pilot Catastrophe Services, INC
10.2018 - 12.2019
- Addressed claims for Allstate Insurance as a desk adjuster
- Processed initial claims
- Understanding of policies: state certifications
- Setting up appointments
- Followed company and insurance client guidelines in claim processes, estimate writing, and claim closure
- Looked into and assessed property damage, as well as reviewing property damage estimates for initial and supplement claims
- Documenting all activities associated with a claim
- Providing excellent customer service through the entire claims process.
Dining Room Coordinator
IAP World Services
09.2012 - 10.2018
- Responsible for the scheduling of the DROs shifts and special duties (cleaning/replenishing the slushy and ice cream machines)
- Set and oversaw weekly and special event menu plans.
- Established a welcoming environment for all guests by maintaining a well-organized, clean, and visually appealing dining area.
- Maintained clean, safe and hazard-free work environment.
Education
Associate of Science - Business Administration
Bishop State Community College
Mobile, AL06.1989
Skills
- Strong Communication Skills
- Great Interpersonal Skills
- Research Skill
- Claims Processing
- Coverage Assessments
- Claims Handling and Investigations
- Insurance Regulations
- Damage Estimating
Certification
- Xactimate
- Xactanalysis
- LA Citizens LIGA
- Guidewire
- Next-Gen
Military Occupation Specialty
Personnel Administration Specialist
State Licenses
Alabama, Florida, Georgia, Kentucky, Louisiana, Montana, North Carolina, South Carolina, Texas
Timeline
Residential-Desk Adjuster
Mid America Catastrophe Services
09.2022 - 10.2023
Residential-Claims Adjuster
Mid America Catastrophe Services
09.2021 - 04.2022
Residential-Claims Adjuster
One Call Claims
10.2020 - 08.2021
Residential-Claims Adjuster
Pilot Catastrophe Services, INC
10.2018 - 12.2019
Dining Room Coordinator
IAP World Services
09.2012 - 10.2018
Associate of Science - Business Administration
Bishop State Community College
- Xactimate
- Xactanalysis
- LA Citizens LIGA
- Guidewire
- Next-Gen
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