Theodora Sagoe

• Managed large loss property claims, including total loss, partial fire loss and smoke claims.
• Analyzed scope, causation, and damages for dwelling, other structures, personal property, and loss of use.
• Interpreted complex policy language, including coverage, exclusions, endorsements, limits, and deductibles.
• Reviewed and validated field adjuster reports, Xactimate estimates, photos, diagrams, and expert findings.
• Coordinated with engineers and vendors for expert investigation for causation and evaluation.
• Reviewed and negotiated supplements, contents inventories, Provide clear explanations of coverage, claim decisions, and payment determinations.
• Prepared coverage determinations, reservation of rights, and denial correspondence when applicable.
• Ensured regulatory compliance and maintained accurate, well-documented claim files.
• Performed regular file audits to monitor adherence to company and regulatory quality standards.
• Delivered clear, empathetic communication to insureds throughout complex and catastrophic loss events.
• Acknowledged by insureds and public adjusters for proactive communication and efficient claims resolution.

• Investigated, evaluated, and settled residential homeowners claims by gathering all loss details, documents and applying in depth knowledge of insurance policies, regulations and building ordinance and law.
• Conducted virtual inspections via live video calls and reviewed photographs, statements, reports to create accurate insurance estimates.
• Interviewed claimants to confirm loss details and expedite claims resolution.
• Analyzed policy language, hurricane deductibles, endorsements, exclusions, and limits.
• Determined cause of loss and verified applicability of windstorm or named-storm deductibles.
• Prepared coverage letters, reservation of rights, and denial letters as needed.
• Reconciled mitigation and repair estimates and supplements while providing exceptional customer service.
• Negotiated settlements with insureds, contractors, and public adjusters.
• Processed supplemental claims and reconciled discrepancies in estimates.
• Closed claims in a timely manner, ensuring efficient resolution and customer satisfaction.

• Made prompt contact with insured to set expectations, developed 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 to 30 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.

• Reviewed claim documents to determine coverage for both daily and catastrophic claims.
• Determined appropriate property claim coverage using virtual tools while delivering exceptional customer service.
• Managed high-volume claims, reducing processing time and ensuring timely closures.
• Negotiated settlements with public adjusters, attorneys, and recommended Appraisal Awards outside authority limits.
• Coordinated vendors, field adjusters, experts, and restoration services, including water and mold mitigation.
• Utilized claims management software for documentation, tracking, and Assignment of Benefits review.
• Maintained complete and accurate claim files throughout the claim lifecycle.
• Recommended SIU referrals and assisted with subrogation recovery when appropriate.
• Consistently improved customer service ratings and achieved 80% satisfaction among clients and public adjusters.

• 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 managing 25 live calls per day.

• 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
• Achieved 20% 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.

• 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
• Explained product changes, restrictions, benefits, requirements, and other relationship banking related product information to customers, resulting in 75% of branch sales goals.