1014 Wall road, Apt. H-8 a- Spring Lake Heights, NJ 07762
(732) 359-6010 a- mp1301624@westpost.net SENIOR CLAIMS ANALYST / EXAMINER Strategic Leader with Proven History of Strong Analytic and Efficient Case Manag ement Skills Investigate, evaluate and settle claims, applying technical knowledge and human relations skills. Vast knowledge of Insurance and Employment Law. Create and Implement claims processes to increase productivity. Natural leadership capabilities to support organization goals and growth profit ability. Ability to conduct qualitative/quantitative research and provide solutions. Comprehensive understanding of the litigation process. CORE PROFESSIONAL STRENGTHS a- Claims Management a- Risk Management a- D&O a- Interface with Multiple Teams a- Asset Protection a- E&O a- Research & Analysis a- Innovative & Knowledgeable a- Effective Negotiator a- Proficient Case Management a- Meet & Exceed Project Deadlines a- Litigation Strategies a- Identify & Resolve Issues a- Proactive Problem Solving a- Optimize Resources PROFESSIONAL EXPERIENCE
Law Office of Michael E. Pruneau, Spring Lake Heights, NJ 2009 to 2011 Consultant a Provide legal services to clients in the areas of real estate, wills and in ma tters involving powers of attorney and landlord-tenant matters. CNA Insurance Company, New York, NY 2005 to 2009
Senior Claims Analyst a Represented and defended claims for architects, engineers, all cooperatives an d Board of Directors for condominiums insured under CNA Insurance Company. a Managed the litigation process, formulating litigation strategies ensuring tim ely and cost effective claims resolution. a Conducted complete investigation and claims analysis to identify proper resolu tion on all assigned claims to provide accurate facts for disposition. a Interpreted and analyzed insurance contract as applied to the exposures presen ted with each assigned claim. a Evaluated and negotiated the resolution of claims, while mitigating damages, t o achieve cost-effective claim outcomes resulting in a high degree of settlement s avoiding protracted legal proceedings. a Reviewed reserves on all assigned claim files and recommended changes where ne cessary to ensure actuarial accuracy. a Negotiated the settlement of assigned claims within authorized amounts or spec ific file authority to produce appropriate outcomes. a Served as an expert resource and handled complex claims maintaining contact wi th the insured in collaboration with defense counsel. a Demonstrated expertise in a wide range of cases with a specialization in EEOC issues and wrongful termination claims. a Handled a very active, complex and high-volume caseload. American International Group, New York, NY 2000 to 2005 Claims Analyst IV a Hired as Claims Analyst III then promoted to Claims Analyst IV handling over 2 00 claims and complex cases with settlements of up to $700,000. a Defended against insurance agents involved in misrepresentation and breach of aDuty of Good Faith and Fair Dealing.a a Represented a few of the largest financial institutions and insurance companie s such as ING, State Farm, and Mass Mutual. a Achieved a 90% settlement-to-trial ratio while protecting companyas assets thr ough effective claims, analysis and management, settlement negotiations, and col laborations with defense counsel. a Represented clients in NASD arbitrations and mediations. a Partnered with and maintained flow of communication between claimant, financia l institutions, legal and any other sources to assure timely handling of claim. a Understood and implemented appropriate claims processes and courses of action when adjudicating claims, to include new day claims, claims requiring research, and claims requiring adjustments. a Defended employees on wrongful termination charges in reference to the employe e practices liability insurance. Prudential Insurance Company, Newark, NJ 1997 to 2000 Senior Claims Examiner a Recruited as Claims Examiner and promoted within 18 months by providing leader ship, mentoring, and support to team of claim specialists. a Oversaw up to 6 direct reports supervising how claims were rated and assured a ppropriate level of relief was rendered. a Reviewed and processed complex claims by analyzing severity of allegations, ob taining and reviewing data to determine risk and exposure and indentify appropri ate class of relief. a Managed claims through well-developed action plans for an appropriate and time ly resolution. a Involved in remediation program for the individuals that were defrauded in Nat ional Class Action Suit representing Prudential on arbitration board when claims appealed for greater relief. a Skillfully avoided arbitration and awarded modified relief in 60% of cases in class action suit where plaintiffs received full relief or filed for arbitration . EDUCATION Seton Hall University School of Law, Newark, NJ Juris Doctor (JD) Rutgers University, New Brunswick, NJ Bachelor of Science in Business Management Several Professional and Personal References furnished upon request