THEODORA A SAGOE
Grand Prairie,TX
Summary
Experienced with property claims examination, specializing in thorough investigation and evaluation of claims. Utilizes strong negotiation skills and analytical abilities to ensure accurate and fair settlements. Knowledge of industry regulations and best practices, consistently delivering high-quality results.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Independent Property Claims Examiner-CAT-Beryl
Pilot Catastrophe Services
07.2024 - 12.2024
- Handled property claims to determine coverage based on policy and carrier guidelines.
- Diligently reviewed reports to ensure that no errors have been made in the appraisal process.
- Verified facts and determine coverage by evaluating policy provisions and endorsements.
- Maintained detailed documentation and follow up on each file.
- Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
- Examined documents for completeness, accuracy and conformance to carrier guidelines and policies.
- Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
- Developed excellent rapport with policyholders by providing clear communication on claim progress and potential outcomes.
- Worked well in a team setting, providing support and guidance.
Independent Property Claims Examiner
Allcat Claims Service
09.2023 - 04.2024
- Made prompt contact with insured to set expectations, develop action plan, for initial exposure assessment
- Interviewed insured, reviewed loss details, explained named peril, long term water damages and mechanical damages to policy holders for fair settlements on claim resolutions, customer satisfaction and excellent cost management
- Confirmed coverage of each claim by reviewing policy endorsements and exclusions to make coverage determination
- Coordinated with Temporal Housing Companies to relocate policy holders during remediation
- Processed Additional Living Expenses
- Reviewed General Loss Report, photos and estimate from Field Adjusters for claim resolution and payment
- Managed assignments with program and non-Water Mitigation, Temporal Housing, and reconstruction
- Engaged specialized departments such as Special Investigation Unit and Subrogation as appropriate
- Made recommendations to management for settlement amounts outside of authority limits
- Responded to30 phone calls from policyholders, agents, and other stakeholders regarding claim status
- Provided guidance and support to new adjusters, assisting with difficult cases and professional development
Independent Property Claims Adjuster
CNC Catastrophe & National Claims
12.2021 - 07.2023
- Investigated First Notice of Loss files and any other documents relating to claims, to accurately estimate claims by reviewing policy contracts to determine claim coverage based on cause and facts of loss
- Investigated and determined appropriate coverage for Property claims through virtual tools, while providing exceptional customer service
- Reduced claim processing time by effectively managing high volume of daily claims
- Negotiated with Public Adjusters and Attorneys for claim settlement and General Release
- Managed and coordinated vendors, field adjusters, insured representation, experts, and emergency repair, Water and Mold Mitigation services and various restoration services
- Maximized productivity with proficient utilization of claims management software for documentation and tracking purposes
- Reviewed Assignment of Benefits from Contractors for invoice payments
- Maintained accurate and current claim file documentation throughout life cycle of claim cases
- Recommended referral to Special Investigative Unit where appropriate and may assist subrogation recovery in their investigation and settling of claim
- Made recommendations to management for settlement amounts outside of authority limits on Appraisal Awards
- Closed claim files upon completion of final payment in accordance with claim compliance procedures
- Improved customer service ratings by consistently providing timely responses to inquiries and concerns from policyholders
- Secured80% of client and Public Adjuster satisfaction
Independent Auto Claims Adjuster
Alacrity Solutions
06.2021 - 10.2021
- Conducted proper claim investigations, from First Notice of Loss files in manner consistent with specific state regulations, policy provisions and standard operating procedures
- Determined liability outlined in coverage and assessed documentation from photos, police reports and recorded statements from insured's, claimants and witnesses
- Maintained diary of pending files and updated information to ensure record of claims with continual review and monitored progress
- Followed up with Body shops on repairs works on vehicles and liaised Car Rental Companies, towing, and settlement of total loss vehicles
- Determined if subrogation exists and took steps necessary to initiate recovery
- Answered calls from customers in courteous, emphatic and professional manner, while managing25 live calls per day
Independent Property Claims Adjuster
Pilot Catastrophe Services
03.2021 - 05.2021
- Examined claims forms and other records to determine insurance coverage
- Assisted policyholders throughout claims process, providing clear explanations of procedures and coverage
- Scoped damages on live video with insured, took photos and verbal description of damages
- Achieved20% reduction in claim processing time by streamlining workflow and implementing new digital tools
- Maintain up-to-date knowledge of industry trends, regulations, and best practices to ensure compliance and improve service quality
- Enhanced client satisfaction by efficiently settling property claims through accurate assessment and negotiation
- Assisted homeowners by coordinating with vendor services, for emergency mitigation and repair
- Consistently met performance metrics, including customer satisfaction scores and claim resolution times
- Ensured proper payment calculations by accurately interpreting policy coverage details in relation to individual claim circumstances
Retail Banker II
WoodForest National Bank
06.2019 - 12.2020
- Offered clients advice and guidance on digital and self-serve options to make banking easy and fast
- Established due diligence in account opening by applying KYC procedures
- Operated money counters, balanced, and replenished ATM
- Researched and resolved customer issues on personal savings, checking, and lines of credit accounts
- Filed disputes on Debit cards , communicated with customers on card dispute resolution
- Explained product changes, restrictions, benefits, requirements, and other relationship banking related product information to customers, resulting in75% of branch sales goals
Education
Associate of Arts - Business Administration
Cambridge International College
Jersey ,United Kingdom04.1995
Skills
- Claims Investigation and Evaluation
- State Insurance Laws and Regulations
- Customer Service and Active Listening
- Claims Resolution and Negotiation
- Fraud Prevention
- Policy Interpretation
- Attention to Detail
- Time Management
ADJUSTER LICENSES
TX LA MS AL GA SC NC FL KY WV IN RI CT DE NH VT MI MN OK WY NM AZ ID NV AK OR WA
Certification
- 2612485, Adjuster (Adjuster - All Lines), The Institutes',900558209,2023
- CRCMP#362940, Certified Risk and Compliance Management Professional, International Association of Risk and Compliance Professionals (IARCP)
- FEMA – NFIP Training Certificate (March2024)
Timeline
Independent Property Claims Examiner-CAT-Beryl
Pilot Catastrophe Services
07.2024 - 12.2024
Independent Property Claims Examiner
Allcat Claims Service
09.2023 - 04.2024
Independent Property Claims Adjuster
CNC Catastrophe & National Claims
12.2021 - 07.2023
Independent Auto Claims Adjuster
Alacrity Solutions
06.2021 - 10.2021
Independent Property Claims Adjuster
Pilot Catastrophe Services
03.2021 - 05.2021
Retail Banker II
WoodForest National Bank
06.2019 - 12.2020
- 2612485, Adjuster (Adjuster - All Lines), The Institutes',900558209,2023
- CRCMP#362940, Certified Risk and Compliance Management Professional, International Association of Risk and Compliance Professionals (IARCP)
- FEMA – NFIP Training Certificate (March2024)
Associate of Arts - Business Administration
Cambridge International College
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