Troy Nelson
Bismarck
Summary
.
Knowledgeable Claims Adjuster with solid background in analyzing claims and determining coverage. Successfully managed complex cases with focus on thorough investigation and timely resolution. Demonstrates proficiency in negotiation and customer service skills.
Experienced with evaluating insurance claims and determining appropriate actions. Utilizes analytical skills to assess damage and liability. Strong understanding of policy coverage and effective negotiation techniques.
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Outside Adjuster
North Dakota Insurance Reserve Fund
07.2015 - Current
- Maintains strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
- Ensures compliance with state regulations and company policies through diligent review of all claim-related materials.
- Improves claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
- Reviews police reports, medical treatment records, and physical property damage to determine extent of liability.
- Leverages strong negotiation skills to resolve claim disputes, resulting in favorable settlements for both the company and policyholders.
- Conducts on-site field inspections to assess damages firsthand, allowing for more accurate estimates and informed decision-making regarding repair costs or total loss assessments.
- Participates in ongoing professional development opportunities to maintain current knowledge of insurance laws, regulations, and best practices within the field of claims adjustment.
- Conducts comprehensive interviews of witnesses and claimants to gather facts and information.
- Negotiates favorable claim settlements by utilizing strong communication and persuasion skills.
- Maximizes cost savings through strategic negotiation tactics during settlement discussions with medical providers or opposing counsel parties involved in disputes or litigation proceedings related to assigned claims cases.
- Maintaines up-to-date knowledge of industry regulations, legal developments, and emerging risks to ensure company readiness for any challenges that may arise.
- Conductes thorough investigations for accurate liability determination, leading to fair claim resolutions.
- Develops strong relationships with external partners such as healthcare providers, attorneys, and law enforcement agencies to facilitate effective claim handling processes.
Senior Claims Specialist
State Farm Insurance
02.1996 - 07.2015
- Maintained compliance with regulatory requirements through diligent documentation of all claim activities.
- Conducted thorough investigations for accurate liability determination, leading to fair claim resolutions.
- Maintained up-to-date knowledge of industry regulations, legal developments, and emerging risks to ensure company readiness for any challenges that may arise.
- Mitigated potential losses by identifying fraudulent claims and coordinating with the fraud investigation unit.
- Negotiated favorable claim settlements by utilizing strong communication and persuasion skills.
Education
Bachelor of Science - Finance
Minot State University
Minot, ND05-1992
High School Diploma -
Minot High School
Minot, ND05-1988
Skills
- Claims investigation
- Damage assessment
- Critical thinking
- Policy interpretation
- Claims analysis
- Teamwork and collaboration
- Decision-making
- Insurance policy knowledge
- Problem-solving abilities
- Multitasking Abilities
- Reliability
- Excellent communication
Certification
- AINS, AIC, and SCLA designations.
- Currently working on my CPCU designation.
Timeline
Outside Adjuster
North Dakota Insurance Reserve Fund
07.2015 - Current
Senior Claims Specialist
State Farm Insurance
02.1996 - 07.2015
- AINS, AIC, and SCLA designations.
- Currently working on my CPCU designation.
Bachelor of Science - Finance
Minot State University
High School Diploma -
Minot High School
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