Scott Hermosa
San Antonio,TX
Summary
Experienced adjuster with extensive claim handling at Fred Loya Insurance and USAA, excelling in litigation claims management and negotiation strategies. Proven ability to assess complex cases and achieve favorable settlements while ensuring compliance. Possesses strong multitasking skills and a commitment to customer service.
Overview
37
37
years of professional experience
Work History
Litigation Adjuster
Fred Loya Insurance
San Antonio, TX
05.2013 - 02.2026
- Analyze policy language to verify coverage validity.
- Assess loss facts utilizing photographs, diagrams, police reports, and additional evidence to establish liability.
- Set proper reserves.
- Handle the distribution of various official correspondence, including Reservation of Rights and settlement letters.
- Handle high exposure claims from the first notice of loss to include severe objective injuries/fatalities.
- Attend mediations as needed to negotiate settlements and resolve disputes outside of court.
- Handle legal documents and maintain communication with defense counsel to ensure deadline are met.
- Collaborate with defense counsel on expert selection.
- Assess medical bills, records, and recommend procedures.
- Monitor developments during trial proceedings in order to ensure that client interests are protected.
- Evaluate and respond to demands properly.
Auto Claims Manager
Fred Loya Insurance
San Antonio, TX
04.2023 - 12.2023
- Reviewed claims for settlement authority and resolution.
- Responsible for a span of 4-5 claim adjusters.
- Managed all phases of claim handling through disposition or transfer to litigation if a lawsuit was filed.
- Prepared and presented serious bodily injury claims to upper management for proper settlement authority.
- Promoted company culture and procedures, ensured alignment, and addressed appropriately adverse trends.
Represented Bodily Injury Adjuster
Fred Loya Insurance
San Antonio, TX
02.2007 - 05.2013
- Conduct interviews with claimants, witnesses, and medical professionals to obtain relevant claim information.
- Handle the resolution of attorney represented claims ensuring timely and accurate evaluation of demands.
- Evaluate medical bills and records to assist the reasonableness and necessity of incurred expenses.
- Answer demands with their conditions promptly, as per regulations.
- Resolve various exposures through negotiations with claimant attorneys.
- identify and refer suspicious claims to the Security Investigative Unit.
Subrogation Specialist
USAA
San Antonio, TX
05.1995 - 02.2007
- Handled subrogation claims by assessing liability and determining recovery potential.
- Collaborated with attorneys and collection services to negotiate settlements and increase resolution processes.
- Reviewed documentation for accuracy, ensuring compliance with regulatory standards.
- Employed claims processing systems to track and manage case progress efficiently.
Auto Claims Adjuster
USAA
San Antonio, TX
05.1989 - 05.1995
- Conduct interviews with claimants, witnesses, and medical professionals to obtain relevant claim information.
- Handle the resolution of auto claims ensuring timely and accurate evaluation of demands.
- Evaluate medical bills and records to include the reasonableness and necessity of incurred expenses.
- Answer demands with their conditions promptly, as per regulations.
- Resolve various exposures through negotiations with claimant attorneys.
- Identify and refer suspicious claims to the Security Investigative Unit.
Education
Bachelor of Arts - Business Administration
Texas Southmost College
Brownsville, TXBBA - Finance
St. Mary’s University
San Antonio, TX12.1988
Skills
- Claims investigation
- Litigation Case evaluation
- Claims management
- Settlement strategies
- Customer service
- Multitasking and organization
Timeline
Auto Claims Manager
Fred Loya Insurance
04.2023 - 12.2023
Litigation Adjuster
Fred Loya Insurance
05.2013 - 02.2026
Represented Bodily Injury Adjuster
Fred Loya Insurance
02.2007 - 05.2013
Subrogation Specialist
USAA
05.1995 - 02.2007
Auto Claims Adjuster
USAA
05.1989 - 05.1995
Bachelor of Arts - Business Administration
Texas Southmost College
BBA - Finance
St. Mary’s University