Dynamic and results-driven professional independent claim adjuster with expertise in personal, property and casualty loss and damages with multi-channel communication, negotiations, conflict resolution and customer/client relationship management. Skilled at applying creative approaches to complex resolution with fairness and thoroughness. Well developed appraisal and third-party settlement negotiations.
Hi, I’m
LYDIA EVANS
Claims
Carrollton,TX
Summary
Overview
18
years of professional experience
3
years of post-secondary education
Work History
Eberl Claims Service Carrollton , TX
Complex Claim Adjuster
02.2023 - 08.2023
Job overview
- Collaborate with cross-functional teams to ensure an efficient flow to the claims process
- Conduct thorough research and analysis to identify and extend policy coverage
- Act as the main point of contact for insureds and third parties, providing exceptional customer service and resolving any issues or concerns promptly
- Establish and manage expense reserves appropriate for each claim loss.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
UPC Insurance Carrollton , TX
Complex Claims Adjuster
08.2021 - 02.2023
Job overview
- Examined claims forms and other records to determine insurance coverage.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Negotiate represented claims in lieu of appraisal and/or suit with a 95% settlement rate.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Prepare contractual claim releases per each successful negotiations
- Proficient in the ability to reconcile and validate Xactimate estimates.
- Conducted roundtable meetings with management and counsel to determine the best course of action.
- Examine and review pr-litigated claims for possible settlement negotiations
American Claims Management ServicesCarrollton , TX
Claims Adjuster
01.2021 - 08.2021
Job overview
- Determine coverage by investigating damages and negotiate a claim settlement in accordance with business best practices for TPA for several carrier policies
- Perform thorough investigation, confirm and interpret coverage with insureds, agents and third-parties
- Assessed client needs evaluated coverages risk exposure while organizing all responsibilities account maintenance
- Substantiated legitimate claims and denied unjustified claims.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Prepared summaries of damage, payments, and policy coverage.
Bear River MutualIrving , TX
Claims Examiner
09.2020 - 01.2021
Job overview
- Investigated and processed CAT, daily, and water insurance claims for policyholders.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Review, negotiate and reconcile mid to high supplements
- Investigated and assessed damage to property and reviewed property damage estimates.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.
- Maintained contact with claimants and attorneys to determine treatment status.
SedgwickDallas , TX
Complex Claims Adjuster
02.2019 - 09.2020
Job overview
- Apply discretion to help solve problems of various scope and complexity
- Review, negotiate and reconcile mid to high supplements
- Review pre-litigated claims and maintain contact with claimants and attorneys to determine treatment status
- Adjust and negotiate claims involving litigation, arbitration or mediation requiring coordination with legal counsel and public adjuster
- Respond to Civil Remedy Notices and DOI complaints prior to suit
- Reviewed accuracy and validation of assignment of benefits
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
Liberty MutualFt Worth , TX
Team Lead
04.2016 - 02.2019
Job overview
- Examine field adjuster’s completed reports including photos, estimates, loss report, and sketches
- Collect contents inventories, ownership support, or any other information necessary to settle content loss
- Collaborate with field adjuster’s Xactimate estimate to review for accuracy and confirm damages written in accordance with Liberty Mutual estimating guidelines and policy coverage
- Provide exceptional customer service through consistent communication, status updates, and thorough explanation of processes
- Review files and reconciled estimates for supplement consideration
- Work directly with contractors to come to an agreed scope of repair
- Coached team members in techniques necessary to complete job tasks.
- Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
- Worked different stations to provide optimal coverage and meet production goals.
- Directed and supervised team of 10-12 claim examiners
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Collaborate with field adjuster’s Xactimate estimate to review for accuracy and confirm damages written in accordance with Liberty Mutual estimating guidelines and policy coverage
- Monitored time and attendance, enforcing compliance with company procedures relating to absenteeism.
Capital OnePlano , TX
Underwriter
01.2006 - 01.2016
Job overview
- Determined and documented loan conditions and communicated requirements and decisions.
- Maintained meticulous attention to detail in underwriting mortgages. Evaluated the financial strength of borrowers to determine risk and repayment capacity.
- Built strong relationships with lenders, brokers and clients for constructive communications.
- Examined credit reports, financial statements and tax returns to determine repayment capability.
- Supported review, acceptance, or denial of new or renewal business after carefully reviewing all information.
Education
University of PhoenixDallas, TX
Bachelor of Science from Science Business Administration
2005.01 - 2006.01 (1 education.year_Label)
University Overview
University of PhoenixDallas, TX
Master of Science from Management
2006.04 - 2008.01 (1 education.year_Label & 9 education.months_Label)
University Overview
Skills
- Negotiation
- Team Leadership, Training and Development
- Conflict Resolution
- Relationship Management
- 27 Claims Adjuster Licenses
- Damage Claim Negotiation
- Customer Service
- Analytical Decision Maker
- Skilled Multi-Tasker
- Interpersonal Skills
- Team Player
- Self-Starter
Timeline
Complex Claim Adjuster
Eberl Claims Service
02.2023 - 08.2023
Complex Claims Adjuster
UPC Insurance
08.2021 - 02.2023
Claims Adjuster
American Claims Management Services
01.2021 - 08.2021
Claims Examiner
Bear River Mutual
09.2020 - 01.2021
Complex Claims Adjuster
Sedgwick
02.2019 - 09.2020
Team Lead
Liberty Mutual
04.2016 - 02.2019
University of Phoenix
Master of Science from Management
2006.04 - 2008.01 (1 education.year_Label & 9 education.months_Label)
Underwriter
Capital One
01.2006 - 01.2016
University of Phoenix
Bachelor of Science from Science Business Administration
2005.01 - 2006.01 (1 education.year_Label)
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