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Auto Claims Adjuster Resume Samples
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0-5 years of experience
Investigated and resolved liability exposures in over 15 states while abiding by those states' specific statutes.
- Negotiated liability exposures and subrogated claimant carriers on behalf of policyholders.
- Resolved hundreds of bodily injury claims, assisting to meet and exceed office goal severities.
- Educated and informed the insured on their policy and the claims process, personally yielding higher customer service than targeted by company goals.
- Organized and prioritized time sensitive projects and claims, including total loss vehicle claims and catastrophe claims.
0-5 years of experience
Investigated auto claims by interviewing the claimant and witnesses, consulting police records and inspecting vehicle damage
- Evaluated claims to ensure validity, determine liability, and negotiate settlement value
- Assisted managers with loss reports, confirming coverage, and answered member inquiries
- Led a team of 20 peers in presenting an out brief to the CEO, president, and executives of USAA
- Shadowed examiners, actuaries, underwriters, and lawyers to expand knowledge of the industry
- Provided alternative solutions to challenges within the business of Property & Casualty
0-5 years of experience
Managed a team of sixteen adjusters responsible for the processing of personal auto liability cases.
- Tracked and compiled performance measurement data for reporting to higher management.
- Monitored and distributed employee workloads to promote efficiency and effectiveness.
- Negotiated customer service escalations and technical questions with expert knowledge of insurance regulations and insurance policies.
- Serviced as a liaison between the local territory manager and team members on all process, policy and personal issues.
- Mentored, evaluated and counseled employees on performance expectations and career succession.
0-5 years of experience
Started as an Auto Claims Service Assistant and later promoted to the Specialized Claims Retention Team involving bodily injury, complex property damage and liability investigations. As a key member of the team, work was completed with great attention to detail, effectively multitasking and providing remarkable service to both customers and business partners.
- Developed and applied knowledge of insurance contracts, customer service philosophy, automotive repair methods and parts and medical and anatomical terminology.
- Served as a resource to senior management by providing vital feedback on current company procedures and workflow to create needed improvements.
- Presented new workflow and procedures to small and large groups of staff members to ensure company consistency.
- Developed key forms and procedures that were introduced and used throughout the department.
- Created and improved existing company workflows within the enterprise to generate greater efficiency and accuracy.
- Built strong relationships with associates and service providers to achieve companywide goals that better improved sales and profits.
- Provided various claim reports to executive management.
0-5 years of experience
Administered 30-day pre-suit demands on files while analyzing cost effectiveness and resolve.
- Reviewed insurance policy form endorsements and other records to determine accuracy in billing processing and reductions.
- Analyzed Independent Medical Examination and Examination Under Oath reports, honoring or overturning same based on legal defense strategy.
- Approved coverage according to business decision on questionable issues, in avoidance of further legal costs.
- Negotiated with provider attorneys, responding and settling within the company's monetary position.
6-10 years of experience
Investigated and resolved in excess of five thousand claims in eight states throughout tenure
- Developed a strong understanding of legal issues and application of provisionary policy language to an array of claims issues
- Applied policy provisions when appropriate and recommended denial of coverage in cases of fraud or policy exclusion
- Reviewed medical bills and determined compensability for injured parties
- Negotiated fair settlements of bodily injury claims with claimants and attorneys
- Assisted supervisor by authorizing checks and approving denials requested by other team members
0-5 years of experience
Investigated claims by interviewing the claimant and witnesses, consulting police and medical records, and inspecting property damage to determine the extent of the company's liability.
- Corresponded with or interviewed medical specialists, agents, witnesses, or claimants to compile information.
- Assessed the cost or value of a claim and identified fraudulent claims for further investigations.
- Calculated loss payments and approved payment of claims within a certain monetary limit.
- Knowledge and application of insurance policies for proper determination of coverage.
0-5 years of experience
Investigated and resolved first party collision, comprehensive, uninsured motorist property damage and third party rental and loss of use claims.
- Confirmed coverage through accurate application of policy detail, drivers, vehicles and associated coverage.
- Secured recorded statements from insured policyholder, claimants, witnesses, paralegals, attorneys, insurance carriers, Medical providers, agents and others.
- Prepared detailed liability investigation reports for claims involving multiple exposures.
- Set Claim settlement value and negotiated with attorneys to achieve settlement absent of litigation and finalize settlement with release.
- Issued accurate and timely claim payments once coverage, negligence and damages have been confirmed.
- Reviewed all files for potential limits issue and secured all applicable property damage releases.
- Utilized skip tracing software to locate responsible parties and made recommendations based on predetermined criteria.
6-10 years of experience
Analyzed claims to determine extent of company's liability & made approval or denial decisions. Negotiated settlements with claimants, claimant carriers, & body shops in accordance with policy provisions and state guidelines. Collaborated with insurance agents and interviewed claimants to correct errors, rectify omissions and investigate questionable issues.
Outcomes:
- Completed more than 3,500 claims throughout tenure. Provide optimum service to policyholders, negotiated fair settlements and review for possible fraudulent claims.
- Determined the cause and extent of damages.
- Maintained a superior total file quality rating average of 97% in file handling and claims from 2004 to 2011, exceeding the 94% departmental goal.
- Maintained an agreed settlement average of 44%, exceeding the 35% department goal.
- Received Outstanding Customer Service Achievement Award.
0-5 years of experience
Performed customer service from time of accident to solution - providing rental, setting up repairs and completing payment for repairs.
- Lead company with 129% claim closing ratio
- Determined fault of accidents by assessing the damage to the vehicles, and dissecting the accident scene.
- Performed customer service management with claims to ensure customer care.
0-5 years of experience
Handled low to moderate complexity claims with respect to coverage, liability, and injury on a high volume basis.
- Completed in person meets with injured parties, obtained medical bills and records, evaluated and negotiated settlements.
- Completed inspections of vehicles utilizing Mitchell's Ultramate software, paid estimates within my authority, negotiated and reached agreed repair cost with repair facilities.
- Investigated liability and coverage through recorded statements, scene investigations, vehicle inspections, and policy interpretation.
- Responsible for accurate appraisal, evaluation, and salvage disposal of total-loss vehicles.
0-5 years of experience
Initiate contact with insured drivers, claimant drivers and third parties within 24 hours of claim filing
- Interview all parties involved in the accident while investigating the facts of loss to make accurate liability decisions
- Assist with the repair process assigning outside adjusters to inspect vehicles and issue payment
- Assess claims by evaluating loss, including total losses and settling the claim
- Promoted team unity and conducted team building activities
- A part of the mentor program to assist new adjusters transitioning from trainee to adjuster
- Awarded adjuster of the Month for January 2011
0-5 years of experience
- Awarded 2009 Top Performer for claim handling performance
- Elected by peers to represent department on 2010 Work Environment Council (WEC)
- Reorganized company procedure on obtaining customer surveys; fixed 2-3 day delay in resolving customer questions/complaints
- Established utilization of worksheet that elevated quality of claim handling
- Standardized WEC communication process which improved department morale
- Handled multi-state first and third party claims including Total Loss claims
0-5 years of experience
Exercised independent judgment and initiative in handling of claims.
- Investigated and negotiated first and third party claims with authority to negotiate up to $15,000 per claim.
- Conducted loss investigations, screened vehicles, researched missing information on claims and processed payments and followed up on inconsistencies and missing information.
- Evaluated settlement strategies and alternatives.
- Determined settlement value. Analyzed potential costs, benefits and litigation risks. Attended mediations conferences and claims committee meetings to ensure fair and equitable settlement.
6-10 years of experience
Analyzed coverage, investigated and resolved claim issues for first and third parties.
- Determined and apportioned liability of claims for personal and commercial auto.
- Reviewed all necessary documentation, such as statements, police reports, appraisal reports,
- Negotiated with other insurance carriers.
0-5 years of experience
Deliver effective claims support to customers experiencing commercial and personal losses by investigating claims, determining coverage, and making recommendations on issues to determine claim outcomes.
- Interpret the insurance contract and apply that knowledge to each assigned claim in a favorable outcome for the company and our customers.
- Works with a multitude of vendors thru out the claims process on a daily basis to assure timely, cost effective results for our customers.
- Ability to maintain a high amount of new claims on a daily basis while managing to keep up on departmental objectives along with office administrative tasks.
- Working as a mentor with several new employees to assist them in learning their new roles effectively and confidently.
- Achieved and maintained licensing in 15 states, in several different regions of the United States per DOI and legal requirements.
0-5 years of experience
- Reported and logged damages to rental company's vehicles via files and company's database system.
- Maintained damaged vehicles in company fleet, photographed vehicles for estimate of damages and set up payment with insurance adjusters and customers.
- Arbitrated in court on behalf of rental company for damages to rental property.
- Collected over $75,000 in damages from parties involved in damages to rental company's vehicles.
0-5 years of experience
Filed auto damage claims on behalf of clients of damaged repossessed vehicles
- Researched insurance coverage to ensure the existence of a policy at the time of repossession
- Reviewed auto damage estimates and made adjustments when necessary
- Followed up on filed claims in a timely manner in an effort to acquire claim payments for clients
- Supplied pertinent documents to insurance carriers so they could make clear claim decisions
- Adhered to good claim practices, maintained P&C license and continuing education requirements
- Successfully completed Vale Auto Damage Training
0-5 years of experience
Negotiated and settled low impact bodily injury related claims.
- Retained and managed auto damage claims for first and third parties.
- Assessed and addressed coverage and liability concerns.
- Investigated and developed strategies to process claims to conclusion quickly.
- Assured cost-effective resolutions while maintaining high levels of customer service.
- Established and maintained appropriate claim and expense reserves.
- Complied with State specific regulations.
0-5 years of experience
Utilized strategic skills to determine cause, scope and extent of vehicle damages in an automobile accident
- Evaluated claims, made appropriate payments and developed a settlement plan that was deemed fair and just for all parties involved in an accident
- Used critical thinking to assess and negotiate liability, guided clients through claims process
- Maintained consistent commitment to delivering high quality customer service every day
6-10 years of experience
- Focused all efforts on meeting each individual customers' stated or unstated needs and expectations
- Interpreted the policy holders individual coverage, set expectations involving the claim process and resolved all concerns by meeting or exceeding their needs during the claim process.
- 2010 recognized in March issue of Lone Star Magazine for providing outstanding customer service.
- 2009-2010 Selected 3 times by peers as the winner of the Team Member Recognition Program for going above and beyond the daily expectations of customer service.
0-5 years of experience
Proved the ability to excel in a high-volume, high-pressure environment. Successfully managed an average caseload of 75+ files, at any given time, while simultaneously maintaining stellar customer service. Awarded by Management a $500.00 gift card, for delivering and upholding the utmost exceptional customer service, as determined by compliments from customers and peer recognition.
- Investigate, evaluate, and settle automotive physical damage insurance claims
- Prepare complex reports for managed care organizations and insurance companies, ensuring full compliance with agency requirements and tight deadlines
- Maintain claim files and inventory of claims requiring detailed analysis
- Recognize and refer potential fraudulent claim activity
- Fairly and equitably authorize claim payments
- Nationally, I held the highest success rate in explaining the benefits of using a Liberty Mutual partnering auto body shop (Higher customer satisfaction when using our shops vs. shops of choice). Tracked by computer, 97% of my calls resulted in an Insured using our partnering auto body shop. The National average was 40% of calls resulted in an Insured using a partnering auto body shop. Typically, Auto Claim Adjusters who had customers that chose shops of choice were unhappy due to the delay of the damage review process.
0-5 years of experience
- Addressed and resolved claims concerning Florida’s Personal Injury Protection statute.
- Investigated, evaluated, and concluded claims including verification of coverage.
- Negotiated and settled claims with lawyers and other insurance companies.
- Determined liability and monetary value of damages to persons and property.
- Worked with the special investigations unit to suppress fraud and control expenses.
0-5 years of experience
- Determined proper policy coverage and applied where necessary best claims practices to conclude, investigate, evaluate, and negotiate assigned material/physical damage claims cases in accordance with company guidelines.
- Planned and executed all time schedules necessary to promptly and effectively conclude assigned cases.
- Established and authorized reserves and claims payments within the delegated authority.
- Submitted administrative reports as required.
- Properly maintained all assigned company equipment.
10+ years of experience
Handled complex auto accident injury claims
- Policyholders support.
- Managed a monthly inventory of 100-150 claims with a 90% settlement rate within 21 days.
- Evaluated and negotiated bodily injury settlements.
- Handled multiple litigation claims, including mediations and trials.
0-5 years of experience
Determined policy status and coverage. Contacted the insured, claimant and witnesses. Obtained estimates for repair or replacement.
- Evaluated cases for settlement. Negotiated settlements with insured, claimants, and attorneys.
- Documented all activity on a claim file. Concluded each claim on its own merits. Organized each day's activities. Maintained necessary records for reference and diaries.
- Issued claim payments and obtained properly completed releases and proofs of loss when required. Informed underwriting of increased hazards concerning a risk.
0-5 years of experience
Performed Interviews both in person and via the phone with other professionals and people in various stages of stress, anxiety and agitation
- Extensive communication of the status and ongoing activities to all people involved
- Evaluated and analyzed interviews and facts, interpreted laws, regulations and policy conditions and monitored activities to identify possible fraud and/or third part liability
- Considered the relative costs and benefits of potential actions, to render the most appropriate settlement
6-10 years of experience
Process change transactions to Life Insurance policy’s including loans, withdrawal, surrenders, title changes, premium and billing changes.
- Meet daily goals for variable market life policy’s to take full advantage of market fluctuation
- Assist co-workers in processing transactions to meet there goals
- Initiated and completed organizing and maintaining original policy contract
- Performed audits on the death claim project to transfer accurate information to acquiring company
0-5 years of experience
Duties focused on front-line investigation, research, negotiation and management of automotive claims. From FNOL to completion.
- Systems utilized for claims handling: Guidewire, Audatex, ARMS, ISO, Copart, and LexisNexis.
- Obtained statements, determined liability and negotiated settlements.
- Provided customer education regarding the interpretation of policy language.
- Identified and escalated fraudulent claims to the Special Investigations Unit (SIU).
- Determined and applied coverage, identified exclusions and claims process requirements.
- Helped navigate the customer through the claims process, by coordinating with repair
6-10 years of experience
Evaluated, negotiated and resolved Auto claims at the most reasonable cost. Managed Auto Claims expenses relating to upfront storage and two charges. Utilized appropriate Rental Management. Satisfy customer needs and ensure file quality.
- Demonstrated same day voice to voice contact with Auto claims customer expectation while providing quality customer service.
- Reviewed Autosource, repair estimate, photos, and system notes to ensure thorough knowledge of ACV evaluation, coverage, liability and rental issues.
- Established and maintained appropriate claim and expense reserves, while negotiating and settling property damage claims with settlement authority.
- Effective diary management to ensure prompt movement of salvage and auto loss conclusion.
- Achieved timely and optimal payouts results on file inventory. Utilized appropriate mitigation correspondence if applicable.
- Provided solid communication to interact competently with internal and external
- Customers.
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