VALLETTE M. HARRIS
Life & Disability Claims Examiner
BATON ROUGE,LA
Summary
Claims specialist with broad life and disability claims experience, handling investigation, document verification, policy interpretation, and accurate benefit decisions. Recognized for dependable productivity, client service, and independent case management while maintaining compliance and meeting performance goals.
Overview
1
1
Certification
17
17
years of professional experience
Work History
Life Insurance Examiner-WBI
Symetra Financial
Bellevue, Washington
10.2025 - 09.2026
- Supported review of Symetra Financial life insurance applications for policy compliance and completeness.
- Validated medical evidence forms and required signatures to align with underwriting standards, facilitating accurate policy evaluations.
- Applied company guidelines to support policy eligibility and coverage decisions.
- Reviewed life insurance policies to ensure compliance with company standards and regulations, supporting adherence to industry practices.
- Investigated discrepancies between actual death benefits and policy contract benefits to ensure accurate claims processing and resolution.
- Conducted detailed investigations into suspicious policyholder death claims.
- Checked beneficiary details and policy paperwork for accuracy and consistency.
- Reviewed policies to support coverage decisions for approval or denial.
- Assessed customer portfolios to help determine suitable coverage levels and premiums.
- Verified authenticity of customer-submitted documents for life insurance claim processing.
- Followed ethical and legally compliant procedures during investigation work.
- Provided strong customer service through clear communication and active listening.
- Reviewed police reports, medical records, medical bills, and property damage details to assess liability.
- Engaged in discussions about ongoing claims during committee meetings to facilitate resolutions. and issues during claim committee meetings.
Group Life Claims Advocate
Dearborn National Life Insurance Company
Downers Grove, Illinois
10.2010 - 10.2025
- Investigated, evaluated, and decided life insurance claims from first notice to final determination, ensuring adherence to policy terms and company guidelines.
- Supported review of group life insurance claims, including complex adjudication for contestability exclusions and beneficiary disputes.
- Interpreted policy language, contract terms, and beneficiary designations to support accurate, consistent, and defensible claim outcomes.
- Applied strong knowledge of group life insurance policies and regulatory and statutory requirements, including FMLA, ERISA, and HIPAA.
- Used state insurance regulations, ERISA requirements, and claims compliance standards to support handling of complex claim scenarios.
- Managed full caseload independently, prioritizing competing demands to consistently meet service quality and turnaround expectations.
- Reviewed medical records, cause-of-death details, financial documents, and legal instruments such as trusts, assignments, and probate records with strong analytical skills.
- Communicated clearly and compassionately with beneficiaries, funeral homes, attorneys, medical providers, and internal partners throughout claims process.
- Provided customer-focused service with empathy and respect during sensitive life claims, supporting beneficiaries and families through challenging times.
Group Disability Claims Examiner II
Dearborn National Insurance
Downers Grove, Illinois
02.2010 - 12.2012
- Reviewed disability claims for Dearborn National Insurance, ensuring compliance with policy provisions and accurate interpretation of medical evidence.
- Checked physician notes, test results, and treatment records to assess claim eligibility.
- Interpreted plan language, contract terms, and benefit guidelines to support claim decisions.
- Assessed medical evidence and supporting documentation to determine eligibility for disability benefits, facilitating informed decision-making.
- Communicated with claimants, employers, and providers to clarify claim status and streamline required documentation.
- Worked with medical professionals to clarify restrictions, limitations, and return-to-work details.
- Examined discrepancies between submitted documents and case circumstances.
- Followed up with claimants after initial decision to provide guidance or assistance.
- Maintained confidential records and supported claim workflows within Dearborn National Insurance systems.
Intermediate Claims Examiner
Transamerica Life
Plano, USA
02.2013 - 10.2021
- Reviewed life insurance claims for Transamerica Life policy compliance and coverage terms.
- Interpreted policy language to determine claim eligibility and benefit requirements.
- Applied company procedures to process routine and complex claims accurately.
- Evaluated claim files, medical records, and beneficiary documents for completeness.
- Documented claim decisions and file notes in claims management systems.
- Performed data entry into the computer system to record information regarding claim status.
- Participated in quality assurance activities such as peer reviews and audits.
Education
Bachelor of Arts & Sciences - Communications & Journalism
University of New Orleans
New Orleans, LA05-1984
Bachelor of Arts & Sciences - Liberal Arts and Sciences
Louisiana State University
Baton Rouge, LA05-1981
Skills
- Claims investigation
- Policy adjudication
- Contract interpretation
- Medical record review
- Claims systems
- Beneficiary determination
- Document verification
- Case management
- Decision-making accountability
- Critical thinking
- Microsoft Office proficiency
- Customer service and support
- Written communication
- Adaptability
Certification
- Health & Life Insurance Agent-Texas Insurance Department Year 2022
Timeline
Life Insurance Examiner-WBI
Symetra Financial
10.2025 - 09.2026
Intermediate Claims Examiner
Transamerica Life
02.2013 - 10.2021
Group Life Claims Advocate
Dearborn National Life Insurance Company
10.2010 - 10.2025
Group Disability Claims Examiner II
Dearborn National Insurance
02.2010 - 12.2012
Bachelor of Arts & Sciences - Communications & Journalism
University of New Orleans
Bachelor of Arts & Sciences - Liberal Arts and Sciences
Louisiana State University