Tony Marquez
Cicero,IL
Summary
At Assurant, I excelled as a Senior Claims Adjuster, leveraging analytical problem-solving and effective communication to reduce loss ratios significantly. My expertise in claims investigation and customer service, coupled with a knack for regulatory compliance, ensured prompt, fair claim settlements. I mentored new adjusters, underscoring my commitment to excellence and team growth.
Overview
19
19
years of professional experience
Work History
Senior Claims Adjuster
Assurant
Chicago, IL
01.2006 - Current
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated and settled claims according to information presented through reports, research, and data verification.
- Identified and obtained evidence to ascertain claim value.
- Investigated questionable claims to determine payment authorization.
- Gathered information from various third parties to determine claim acceptability.
- Analyzed and audited open claims to calculate additional payments owed.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Decreased loss ratios through fair and timely claim processing.
- Explained premiums owed to policyholders, agents and underwriters.
- Managed caseload effectively, prioritizing urgent or high-value claims for prompt attention.
- Reviewed and applied state laws and regulations to ensure compliance in claim handling.
- Utilized claim handling software to document and manage claim files efficiently.
- Communicated effectively with policyholders, providing updates and explaining claim processes.
- Worked closely with repair facilities and contractors to ensure quality repairs for policyholders.
- Participated in training and mentoring of new claims adjusters, sharing knowledge and expertise.
- Calculated and authorized payment of claims within designated authority level.
- Assisted in fraud detection and prevention efforts by identifying suspicious claim activities.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Input claim information and payments into company database.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Investigated potentially fraudulent claims with focus on thoroughness, quality, and cost control.
- Reduced loss ratios through fair and prompt processing of claims.
Education
Automotive Technician - Automotive
Lincoln Technical Institute
Melrose Park, IL02-2004
Skills
- Strategic Decision-making
- Conflict resolution techniques
- Excellent writing skills
- Regulatory compliance
- Analytical problem solving
- Effective communication
- Claims files management processes
- Insurance fraud expertise
- Automobile appraisals
- Automobile claims specialist
- Decision-making
- Claims processing
- Customer service
- Claims investigation
Languages
Spanish
Native/ Bilingual
References
References available upon request.
Timeline
Senior Claims Adjuster
Assurant
01.2006 - Current
Automotive Technician - Automotive
Lincoln Technical Institute
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