Experience

Gulfshore Insurance, Acrisure Agency Partner

• United States
• Insurance
• 1 - 100 Employee

• Senior Claims Advocate

  • Aug 2016 - Present

  Naples, Florida Gulfshore Insurance is part of Acrisure, a top-five global brokerage. - Property & Casualty - High Net Worth & Family Office - Aviation - Yacht & Watercraft - Auto - Crime & Cyber - Environmental / Pollution - General, Professional & Executive Liability - Inland & Ocean Marine - Employee Benefits - Employment Practices Liability - Workers Compensation & Employer's Liability



Citizens Property Insurance Corporation

• United States
• Insurance
• 700 & Above Employee

• Senior Claims Quality Assurance Field Reinspector

  • 2013 - 2016

  Tampa Bay - Conducted Residential and Commercial daily (non-CAT), catastrophe and sinkhole field reinspections and audits - Remote employee located in Sarasota, FL - Assigned territory covered west coast of Florida from Citrus County to Collier County - Responsible for conducting ride-alongs with management teams to evaluate staff and vendor work product and make appropriate recommendations as necessary - Performed Root Cause Analysis of audit findings - Responsible for compiling monthly… Show more - Conducted Residential and Commercial daily (non-CAT), catastrophe and sinkhole field reinspections and audits - Remote employee located in Sarasota, FL - Assigned territory covered west coast of Florida from Citrus County to Collier County - Responsible for conducting ride-alongs with management teams to evaluate staff and vendor work product and make appropriate recommendations as necessary - Performed Root Cause Analysis of audit findings - Responsible for compiling monthly audit data and preparing and disseminating Key Performance Indicator (KPI) reports by business unit, vendor, team, cause of loss - Performed audits in Aon Inpoint software - Responsible for assessment and reporting of potential underwriting and risk exposure concerns - Participated in live and mock trials and provided feedback to in-house and outside defense counsel and experts - Kept current with case law, legislation and changes in legal climate - Responsible for management role during catastrophe response Licensed in FL, TX, AL, MS, LA - Xactimate Level II Certification - IICRC Water & Fire / Smoke Restoration Certification - FEMA / NFIP Licensed Flood Adjuster - Bilingual (English / Spanish)

• Claims Quality Assurance Auditor

  • 2010 - 2013

  Tampa, Florida - Conducted quality assurance audits of Personal and Commercial Lines Large Loss, Sinkhole, Liability, 3rd party Litigation, 1st party Litigation, Mediation and Appraisal catastrophe and daily claim files. - Reviewed claim files in accordance with company risk profile for potential underwriting and risk exposure concerns - Audited subrogation, salvage and Special Investigations Unit (SIU) referrals for accuracy, compliance and missed opportunities - Performed Root Cause Analysis of… Show more - Conducted quality assurance audits of Personal and Commercial Lines Large Loss, Sinkhole, Liability, 3rd party Litigation, 1st party Litigation, Mediation and Appraisal catastrophe and daily claim files. - Reviewed claim files in accordance with company risk profile for potential underwriting and risk exposure concerns - Audited subrogation, salvage and Special Investigations Unit (SIU) referrals for accuracy, compliance and missed opportunities - Performed Root Cause Analysis of audit findings - Created reports of audit findings - Responsible for compiling monthly audit data and preparing and disseminating Key Performance Indicator (KPI) reports by business unit, vendor, team, cause of loss - Performed targeted audits on Geotechnical Engineers and other vendors to ensure compliance with Service Level Agreements and standards - Participated in group calibrations with management and claims staff to ensure compliance with company procedures, estimating guidelines and Best Claims Practices - Acted as a liaison between claims units and the Claims Quality Assurance Team - Responsible for meeting with staff and vendor management to provide work product feedback and ensure compliance with current guidelines and training on future procedural changes - Assisted in creating and implementing procedures to improve the quality and efficiency of claims processes within individual claims units - Assisted in the creation and implementation of a new team within the Claims Quality Assurance unit, provided training and conducted calibration sessions - Kept current with case law, legislation and changes in legal climate - Responsible for management role during catastrophe response Auditing of Desk and Field Staff Adjusters, Independent Adjusters and Geotechnical Engineers in the following claims units: - Large Loss - Sinkhole - 1st Party Litigation - 3rd Party Litigation - Mediation - Appraisal - Liability - Commercial - Late FNOL

• Managed Claim Model (MCM) Team Lead

  • 2010 - 2011

  Tampa, Florida - Managed team of independent adjusters - Handled a large inventory of multi-peril claims - Negotiated settlements with public adjusters, contractors and attorneys - Determined subrogation potential against responsible third parties - Reviewed and modified estimates from field adjusters in accordance with company estimating guidelines and best practices - Responsible for communicating with claimants regarding initial loss details by conducting recorded interviews, providing claim… Show more - Managed team of independent adjusters - Handled a large inventory of multi-peril claims - Negotiated settlements with public adjusters, contractors and attorneys - Determined subrogation potential against responsible third parties - Reviewed and modified estimates from field adjusters in accordance with company estimating guidelines and best practices - Responsible for communicating with claimants regarding initial loss details by conducting recorded interviews, providing claim status, follow-up and settlement information - Prepared and disseminated letters and documents to claimants including settlement releases, sworn statement in proof of loss, denial, reservation of rights, loss waivers, contact, and settlement letters - Assigned engineers and experts to evaluate property losses, as needed - Reviewed expert reports to determine claim coverage - Consulted with in-house and outside legal counsel on Examinations Under Oath (EUO) and other legal matters - Created and maintained databases tracking current open claim information and potential fraud trends - Trained field adjusters to handle full claim assignments - Conducted claim file audits and provided feedback to field adjusters and management

• Property Claims Adjuster

  • 2009 - 2010

  Tampa, Florida



Texas Windstorm Insurance Association

• United States
• Insurance
• 100 - 200 Employee

• Field Property Claims Adjuster

  • 2008 - 2009

  Houston / Galveston, Texas Area - Handled a large inventory of Commercial and Residential catastrophe claims after Hurricane Ike - Received and processed new assignments - Set appropriate reserves - Scheduled property inspections - Determined cause of loss and scope of damage - Prepared property damage estimates - Prepared reports on claim status including estimate / adjustments, remarks, sketch / diagram, measurements, photos and supporting documentation - Negotiated estimates with public adjusters… Show more - Handled a large inventory of Commercial and Residential catastrophe claims after Hurricane Ike - Received and processed new assignments - Set appropriate reserves - Scheduled property inspections - Determined cause of loss and scope of damage - Prepared property damage estimates - Prepared reports on claim status including estimate / adjustments, remarks, sketch / diagram, measurements, photos and supporting documentation - Negotiated estimates with public adjusters, contractors and attorneys to arrive at a final settlement value - Assessed damage and assigned experts as needed - Reviewed expert (legal, engineering - structural, geotechnical / subsidence, roofing, cause & origin, fire / fraud investigation) reports to determine coverage - Responsible for assessment and reporting of potential underwriting and risk exposure concerns - Determined subrogation potential against responsible third parties - Communicated and corresponded regarding status and disposition of claim with insured, insurance carrier and third parties - Traveled out-of-state on short notice assignments to handle catastrophe claims - Established satellite office with TPA in Houston, TX after Hurricane Ike Show less



Insurance

• Independent Claims Adjuster

  • 2005 - 2009

  Florida - Statewide Residential & Commercial multi-line adjuster handling field claims throughout the State of Florida. - Commercial and Residential Catastrophe Claims - Daily Claims - Disputed Claims - Xactimate / XactAnalysis / XactAnalysis QR - Simbility - Simsol - MS/B IntegriClaim - PowerClaim - Eagleview - ITEL Reports - NFIP Certification



UPC Insurance

• United States
• Insurance
• 100 - 200 Employee

• Field Claims Adjuster

  • 2005 - 2008

  Miami-Dade / Broward / Palm Beach Independent adjuster on assignment with United Property & Casualty Insurance Company through IMS Claim Services and IMS Catastrophe Services. Handled daily and catastrophe multi-peril field claims throughout the State of Florida.