
Dynamic Senior Claims Specialist with extensive experience in claims investigation and regulatory compliance. Proven track record in managing high-exposure claims, negotiating settlements, and mentoring teams. Skilled in data analysis and committed to delivering exceptional customer service while ensuring accurate coverage analysis and policy interpretation.
-Manage portfolio of complex and high exposure claims including losses exceeding $6M
- handle pending volume of 190 open claims
- Handle diverse clams including multinational accounts, commercial PD, Personal Property Claims, Aviation claims, Equipment Breakdown, Course of construction, Energy losses, Cargo/ Marine claims, Entertainment industry losses, Mortgage Impairment and Foreclosed Property claims, CAT claims.
-Lead investigation involving adjusters, brokers, legal counsels, appraisers, third party vendors and forensic experts.
- Confirm coverage and determine liability in accordance with policy terms and regulations.
- Validate claims, insuring information is property collected, analyzed and maintained.
- Negotiate settlement for high exposure claims.
- Collaborate with underwriting teams to resolve discrepancies and enhance process efficiency.
- Facilitated training sessions on new systems and tools to improve team performance and accuracy.
- Analyzed file reports to determine the nature of loss, coverage provided and scope of damages.
- Conducted investigation and secured all supporting documentation to verify same for accuracy, relationship and completeness.
- establish accurate and timely reserves
- maintained active diary and monitor same to achieve active developments
- promptly documented all developments in claim file
- effectively communicated with claims, underwriting, commercial and personal lines, brokers and business partners.
- maintained accurate payment processing and adjustment
- recognized subtraction / salvage where applicable
- adhere to all statutory regulations
Claims investigation
Coverage analysis and policy interpretations
Regulatory compliance
Customer service
Data analysis and reporting