Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tonya Johnson

Riverview,FL

Summary

Meticulous Claims Examiner skilled in adhering to Department of Insurance guidelines in settling and closing claims. Offering 7 years of claims investigation expertise. Strong knowledge of fair claims settlement practices and claims transactions. Profound knowledge of customer service operations. Substantial written, oral communication and interpersonal skills. Immense ability to evaluate property losses, personal injury, and business interruption losses. Outstanding ability to prepare/review damage estimates, negotiate and adequately complete coverage determinations with legal & factual issues, conduct extensive, reasoned legal research. Good judgement in developing and implementing strategies on litigation cases. Ability to uphold the highest standards of service and integrity. Amazing ability to make complex judgments. Leveraged keen attention to detail and strong analytical skills to investigate accidents, assess liability, business interruption, loss of income and determine accurate settlement. Currently licensed in FL, NM, OK, TX, WV.

Overview

6
6
years of professional experience

Work History

Claims Examiner

Typ Tap Insurance
Tampa, FL
04.2019 - 03.2024

• Evaluated & managed 1st party claims & determined future course of handling
• Maintained well-developed action plans for litigated claims in an appropriate and timely
resolution
• Investigated, evaluated, negotiated, settled complex daily property claims; water/backup/sump
overflow, mold, sink hole, fire, theft, vandalism
• Coordinated settlements with insureds, claimants, Public Adjusters & Attorneys for litigated cases
• Identified claims requiring to be reported to SIU, Subrogation and Underwriting
• Received, verified and determined applicability of coverage
• Determined the method & extent of investigation, evaluation, and reserve
• Adjusted reserves adequately on all new and existing claims
• Reviewed Time limit demands from attorneys, determined settlement offer
• Issued payments as per discretionary settlement authority limits
• Reviewed, Negotiated, and Settled Public Adjuster and Contractor’s estimates
• Maintained a timely diary for each case for each claim as required by company Best Practices
• Completed estimates using XactAnalysis, Simsol and Symbility for property damage losses;
worked with and oversaw the work of independent adjusters and vendors; worked with minimal
supervision; catastrophe duty with high claim inventory involving multi-state jurisdictions
• Responsible for handling mid to complex Homeowner’s Property claims from inception to close;
analyzed, investigated, and adjusted moderate to complex personal lines homeowner’s claims
within assigned authority limits
• Reviewed and assessed policies; including coverage applications and making recommendation on
Reservation of Rights or Denial/Partial Denial letters; facilitated repairs to damaged property,
facilitated replacement of destroyed personal property and when necessary, helped customers find
alternate living arrangements

Senior Property Claims Adjuster

People's Trust Insurance Company
Deerfield Beach, Florida
01.2019 - 03.2019

• Responsible for handling mid to complex Commercial Property claims from inception to close;
analyzed investigated and adjusted moderate to complex personal lines commercial claims within
assigned authority limits
• Evaluated, negotiated, settled, litigated, complex commercial property claims in a timely manner
• Ensured integrity of investigations by developing accurate and relevant investigation material &
data acquisition for over 200 pending activity claims
• Identify claims requiring to be reported to SIU, Subrogation and Underwriting
• Coordinated communication with contractors and businesses to negotiate supplement settlements
• Properly reviewed Time limit demands from attorneys, determined settlement offer
• Frequently adjusted reserves adequately on all new and existing claims
• Maintained a timely diary for each case for each claim as required by company Best Practices
• Issued payments as per discretionary settlement authority limits
• Reviewed and assessed policies; including coverage application and making recommendations on
Denial letters; facilitated repairs to damaged property, facilitated replacement of destroyed
personal property
• Worked with minimal supervision; catastrophe duty with high claim inventory
• Worked with Guidewire and PTS systems

Claims Adjuster

Homeowners Choice Property & Casualty Insurance
Tampa, FL
10.2017 - 12.2018

• Evaluated & managed 1st party claims & determined future course of handling • Maintained well-developed action plans for litigated claims in an appropriate and timely resolution • Investigated, evaluated, negotiated, settled complex daily property claims; water/backup/sump overflow, mold, sink hole, fire, theft, vandalism • Coordinated settlements with insureds, claimants, Public Adjusters & Attorneys for litigated cases • Identified claims requiring to be reported to SIU, Subrogation and Underwriting • Received, verified and determined applicability of coverage • Determined the method & extent of investigation, evaluation, and reserve • Adjusted reserves adequately on all new and existing claims • Reviewed Time limit demands from attorneys, determined settlement offer • Issued payments as per discretionary settlement authority limits • Reviewed, Negotiated, and Settled Public Adjuster and Contractor’s estimates • Maintained a timely diary for each case for each claim as required by company Best Practices • Completed estimates using XactAnalysis, Simsol and Symbility for property damage losses; worked with and oversaw the work of independent adjusters and vendors; worked with minimal supervision; catastrophe duty with high claim inventory involving multi-state jurisdictions • Responsible for handling mid to complex Homeowner’s Property claims from inception to close; analyzed, investigated, and adjusted moderate to complex personal lines homeowner’s claims within assigned authority limits • Reviewed and assessed policies; including coverage applications and making recommendation on Reservation of Rights or Denial/Partial Denial letters; facilitated repairs to damaged property, facilitated replacement of destroyed personal property and when necessary, helped customers find alternate living arrangements

Education

High School Diploma -

Thomas Jefferson High School
Tampa, FL
06-1989

Skills

  • Policy Interpretation
  • Claims Processing
  • Investigative skills
  • Insurance knowledge
  • Verbal Communication
  • Team Collaboration
  • Decision-Making
  • Critical Thinking
  • Settlement Negotiations
  • Task Prioritization
  • Analytical Skills
  • Adaptability
  • Property claims
  • Attention to Detail
  • Problem-solving abilities
  • Effective Communication
  • Time management abilities

Timeline

Claims Examiner

Typ Tap Insurance
04.2019 - 03.2024

Senior Property Claims Adjuster

People's Trust Insurance Company
01.2019 - 03.2019

Claims Adjuster

Homeowners Choice Property & Casualty Insurance
10.2017 - 12.2018

High School Diploma -

Thomas Jefferson High School
Tonya Johnson