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Skills

  • BCCORP W5 for Adjusters
  • Fraudulent activity prevention
  • Valuation knowledge
  • Insurance policy coverage knowledge
  • Claim reserves forecasting and accuracy models
  • Familiar with fraud statutes
  • Personal, casualty and property loss
  • Field inspections for high-value losses
  • CCC Pathways Appraisal Quality Solution
  • Cost-benefit analysis for settlements

Work Experiences

  • Assessed vehicle condition.
  • Investigated potentially fraudulent claims that claims representatives had initiated.
  • Organized system data in order to finish program files.
  • Analyzed medical reports in auto injury claims for causality verification, reducing overpayments by $15 in 2022.
  • Advised legal counsel on coverage investigations, strengthening defense strategies in 11-plus high-stake litigated files.
  • Collaborated with forensic engineers and accident reconstruction specialists to gather critical evidence that led to claim dismissal in 77% of cases.
  • Reviewed new files to determine the current status of an injury claim and devise a strategy.
  • Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability.
  • Investigated claims and incident data in order to provide solutions and resolve issues.
  • Was in charge of maintaining claims data in procedure systems.

Summaries

  • Adept at managing litigated files.
  • Dedicated to learning, growing, and succeeding in Insurance.
  • Claims Examiner with extensive experience in the system claims industry.
  • Reliable and trustworthy.
  • Insurance adjuster who investigates and analyzes liability in the event of a personal, casualty, or property loss.
  • Accomplished in handling third-party mediation and arbitration, improving case resolution times by several months while ensuring settlements align with policy provisions.
  • Adept at maximizing customer satisfaction through timely updates and transparency, improving satisfaction scores by 83% and fostering client trust.
  • Solid skills in formulating goals and strategies for resolving initiative claims.
  • Criminal investigation, insurance fraud, and surveillance are all part of his background.
  • Accelerated professional development curve.

Accomplishments

  • Delivered comprehensive training to adjusters on identifying fraudulent activities, resulting in $15 in annual fraud-related cost reductions.
  • Spearheaded a best-practice initiative for managing auto collision claims, adopted company-wide and reducing claim resolution time by 34%.
  • Served as the primary liaison between legal counsel and claimants, contributing to 19% successful claim settlements without litigation.
  • Negotiated equitable and timely settlements in 7 arbitration cases, reducing potential claim liability by 14 annually.
  • Provided multilingual claim support in Portuguese, improving customer satisfaction scores by 61%.
  • Mastered risk mitigation strategies, contributing to a 46% decrease in high-exposure claims over 6 months.
  • Conducted in-depth investigations into auto claims, reducing fraudulent claims by 52% and saving the company $8 annually.
  • Expertly prepared claims for arbitration proceedings, securing favorable rulings in 70% of cases handled.
  • Proactively consulted with legal teams on auto-related lawsuits, contributing to comprehensive legal defense strategies and reducing claim payouts by 11.
  • Collaborated with cross-functional team members to drive continuous improvements, reducing claims disputes by 73% over the past year.

Affiliations

  • Rotary International
  • Lions Club
  • International Council of Nurses
  • Accredited Vehicle Appraisal Institute (AVAI)
  • National Safety Council's Defensive Driving Course Instructor Certification
  • National Association of Subrogation Professionals (NASP)
  • Automotive Service Association (ASA)
  • Project Management Institute
  • Collision Industry Conference (CIC)
  • International Association of Special Investigation Units (IASIU)

Certifications

  • First Aid/CPR Certified
  • National Auto Dealers Association (NADA) Vehicle Repair Estimator Certification – 2018
  • Damage Estimator Certification program – 2018
  • Advanced Auto Claims for Independent Adjusters Certification – Vantage – 2017
  • Collision Repair and Refinish Technician Certification (ASE) – program – 2024
  • Licensed Automotive Damage Adjuster – metric – 2020
  • Commercial & Personal Auto Claims Handling Certification – Harbor & Co. – 2016
  • Occupational Fraud Investigations Certification – procedure – 2019
  • State-Specific Motor Vehicle Damage Appraiser License – Washington – 2015
  • ServSafe

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