Mireya Diaz

Experience

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  State Farm

  Jan 1991 - Jan 2020

  Applied company service philosophy and knowledge of relevant organizational policies/procedures, state/federal laws, and insurance regulations to process high volume complex auto claim assignments and negotiate bodily injury settlements within authority. Managed, negotiated, and settled claims with/without representation and handled 1st & 3rd party litigation files to conclusion, including complex/non-routine lawsuits, alternative dispute resolution, and extra-contractual damage. Attended mandatory mediations and conducted pre-suit mediations. Participated 5 years in intercompany arbitrations.Verified origin of loss, legal liability/exposure, extent of 1st & 3rd party injury/property damage, and reviewed policies to determine appropriate levels of coverage and exclusions for approval or denial decisions. Ensured accurate interpretations with acute awareness of duty to defend potential exposure for bad faith. Average 220 claim files, 95% settled through strong negotiation.Planned, developed, and implemented liability investigations based on claim needs; secured recorded statements of parties involved, scene/vehicle photos to confirm point of impact, and police reports.Identified suspicious losses and partnered with Special Investigation Unit to conduct further inquiries.Performed analysis and provided evaluations to maintain accurate liability estimates on behalf of organization.Liaised/communicated with insured, claimants, agents, service providers, plaintiff & defense attorneys during claim processes to ensure correct interpretation/application of contract provisions and adherence to claim procedures, attending key concerns to deliver first class quality service.Collaborated with claim handling inquiries with other peers & claim segments; trained, coached & mentored new hires and less experienced team members; made appropriate referrals, transfers & escalations; and identified/ensured prompt appropriate routing of claims to other functional areas. Show less

  • Claim Specialist / Auto / Bodily Injury / Litigation | North Carolina & Florida

    Jan 2013 - Jan 2020

  • Claim Specialist, Bodily Injury

    Jan 2001 - Jan 2013

  • Claim Representative, Property Damage

    Jan 1998 - Jan 2001

  • Claim Specialist, Bodily Injury

    Jan 1997 - Jan 1998

  • Claim Specialist, Personal Injury Protection

    Jan 1996 - Jan 1997

  • Claim Specialist, Total Loss

    Jan 1995 - Jan 1996

  • Claim Representative, Property Damage

    Jan 1993 - Jan 1995

  • Claim Representative, Personal Injury Protection

    Jan 1991 - Jan 1993
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  Seeking a New Opportunity

  Jul 2020 - Nov 2020

  CLAIM SPECIALIST

  Committed to furthering my career and seeking to benefit a reputable, dynamic organization requiring a high-performance professional who adapts easily to new concepts and responsibilities, with qualifications to serve as a key player to make significant contributions in continued growth and success. Open to career or industry change in positions related to areas of strength and expertise.I bring in-depth knowledge and 25+ years of extensive experience dedicated to spearheading all facets of insurance claim processes and logistics with strong focus on reviewing claims and litigation files, determining coverage, and presenting information to policyholders, management, and attorneys.Offer exemplary interpersonal skills, compelling management, organizational, and leadership skills, strong sense of teamwork and collaboration, and commitment to excellence delivering first class customer service.Communicate professionally at all levels and possess capacity to build trusted relationships of value that drive collaboration when liaising with staff, peers, senior management, and clients. Show less

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  Assurant

  Nov 2020 - now

  Large Loss Claims Specialist - Bodily Injury