I have several interests outside of the Insurance Industry
I Journal
I Crotchet
I Horse ride
I Travel as much as I can
NICOLA FORRESTER
Summary
Diligent and professional individual with extensive experience in claims adjudication, fraud detection, policy compliance, relationship management, and conflict resolution. Goal is to leverage skills and expertise to excel in a new and exciting claims role to extend my love of learning. Mature professional with honed abilities in diplomacy, positivity, helpfulness, flexibility, and being someone that junior members can learn from. Strong team player who can also work independently and follow directions effectively. Demonstrated adept problem-solving skills and created innovative training tools for consistent processes among adjusters in previous role. Knowledgeable Level 3 adjuster with solid background in analyzing claims and determining coverage. Successfully managed complex cases with focus on thorough investigation, file documentation and timely resolution. Proficient in negotiation and customer service skills. Utilizing analytical skills to assess damage and liability. Strong understanding of policy coverage and effective negotiation techniques.
Overview
26
26
years of professional experience
1
1
Certification
Work History
LEVEL 3 Complex Claims PD Adjuster
CAA INSURANCE CO.
12.2022 - Current
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Prepared summaries of damage, payments, and policy coverage.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Reviewed police reports, members and third party statements and physical property damage to determine extent of liability.
- Maintained compliance with statutory regulatory requirements through meticulous documentation and adherence to company policies.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Collaborated with teams to defend against fraudulent claims, saving company resources and maintaining its reputation.
- Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Maintained claims data in Guidewire, Arms, Mitchell and Microsoft and Excel systems.
- Provided exceptional customer service, addressing concerns, and answering questions promptly.
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Facilitated smooth transitions for policyholders during the claim process by liaising between various departments, ensuring all parties were informed and engaged.
- Developed strong relationships with repair vendors, ensuring quality service and fair pricing for clients in need of repairs after an incident.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Contributed to a positive work environment through active participation in team meetings and collaborating on cross-functional projects.
- Assisting and sharing knowledge and contributing to the teams success.
- Mentored junior adjusters on best practices and industry regulations, contributing to their professional growth and development.
Self Employed Delivery Business
Groovy Routes
10.2003 - 08.2024
- I bid on contracts with Metroland Media to deliver product in York Region
- Also won a contract to deliver GoodFood Fresh food service
- Always punctual, reliable and delivered all product by deadlines and in any weather.
- Hired and managed independent contract drivers to deliver product for my company.
- Dealt with payment, invoicing, budgeting and taxes and all areas of running a small business.
- Managed inventory accurately using company software to ensure correct package selection for each delivery.
- Resolved customer issues promptly and professionally, maintaining a positive brand image.
Music and Art Teacher
Kids Groove Music and Art
09.2003 - 03.2023
- Marketed and Advertised my small business to the community effectively.
- Established and maintained a good rapport with community facilities which provided space for me to run my classes, in regards to negotiating fees, class times, dates and invoicing
- Create an environment that was inviting, stimulating and welcoming to both parents and children to ensure that I had repeat clients
- Deal with customer issues in a professional and courteous manner to be flexible but still maintain a profitable business
- Established strong relationships with parents through regular communication, fostering an inclusive environment for optimal enjoyment.
- Reinforced positive behavior by encouraging efforts through affirmation statements and praising accomplishments.
- Implemented age-appropriate stimuli to meet needs of young learners.
- Organized and supervised large and small group activities.
SIU Claims Adjuster
Economical Insurance Company
01.2002 - 10.2003
- Investigated auto, bodily injury and property claims that had been flagged by adjusters to be suspicious and follow all leads that arose during the investigation
- Completing scene investigations, interviewing claimants, witnesses, completing statement under oath, photographs etc
- Helped develop a new Special Investigation Manual that was given to adjusters to help them identify suspicious claims
- Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
- Identified suspicious losses and contacted manager for investigative assistance.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Worked with private investigators and visited insureds, third party and witness's locations to take recorded statements as tasks for other adjusters.
Automobile and Property Claims Adjuster
Economical Insurance Company
04.1999 - 01.2002
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated
- Evaluate practicality of repair as opposed to payment of market value of vehicle before the accident
- Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken
Education
ATLANTIC LICENSED ADJUSTER - Insurance
Insurance Licensing Board in N/B, N/S And PEI
ONLINE CHARTERED INSURANCE PROFESSIONAL - Insurance
INSURANCE INSTITUTE OF CANADA
REMOTE01-2027
NATIONAL NURSERY NURSE ASSOCIATES DEGREE - Childhood development 0 to 7 years
BROMSGROVE COLLEGE
Bromsgrove, Worcestershire06.1989
Skills
- Policy interpretation and claims file documentation
- Critical thinking
- Risk assessment and management
- Conflict resolution and excellent customer service skills
- Innovation and creativity
- Insurance fraud expertise and Interviewing techniques
- Fact finding, Professionalism and Effective communication
- Claims Investigation, Denied claims identification, and best practices implementation
- Problem-solving abilities, Teamwork and collaboration
- Highly motivated and Adaptable
Accomplishments
- Exceeded my company goal consistently with a closing ratio of 150%.
- Exceeded my present company goal of audited Q and A files with a compliance of 150%
- Exceeded my present company goal of outgoing calls per month achieving 150%
Certification
- Early Childhood Education Equivalency Diploma
Interests
Timeline
LEVEL 3 Complex Claims PD Adjuster
CAA INSURANCE CO.
12.2022 - Current
Self Employed Delivery Business
Groovy Routes
10.2003 - 08.2024
Music and Art Teacher
Kids Groove Music and Art
09.2003 - 03.2023
SIU Claims Adjuster
Economical Insurance Company
01.2002 - 10.2003
Automobile and Property Claims Adjuster
Economical Insurance Company
04.1999 - 01.2002
- Early Childhood Education Equivalency Diploma
ATLANTIC LICENSED ADJUSTER - Insurance
Insurance Licensing Board in N/B, N/S And PEI
CHARTERED INSURANCE PROFESSIONAL - Insurance
INSURANCE INSTITUTE OF CANADA
NATIONAL NURSERY NURSE ASSOCIATES DEGREE - Childhood development 0 to 7 years
BROMSGROVE COLLEGE
Similar Profiles
Angie MarchbankAngie Marchbank
Insurance Broker at Higgins General Insurance Ltd.Insurance Broker at Higgins General Insurance Ltd.
Lauri BenefielLauri Benefiel
Branch Manager at InsureOne Insurance ServicesBranch Manager at InsureOne Insurance Services
TANESHA WILEYTANESHA WILEY
Executive Assistant to Head of Global Touring at CAAExecutive Assistant to Head of Global Touring at CAA