Experience

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  State farm insurance

  Jan 1987 - Jul 2018

  Auto Claims/ Fire Claims /Sr.Claims Specialist.Special Investigation UnitExamines high volume of claims involving NICB indicators of fraud and determines if additional or specialized investigation is appropriate. Evaluates claim Data Analytics to determine patterns of behavior and/or abuse including but not limited to billing, treatment and diagnostic testing from medical providers and treatment facilities.• Develops multiple claim projects including body shop investigations, attorney and provider relationships as well as bodily injury stage and caused losses protecting and saving significant costly dollar amounts.• Testifies on multiple claim investigations at depositions and trials.• Achieved trial results over the last 6 years included 18 cases that had gone to trial and received “no cause” decisions based on the investigation and defense strategies. • Establishes a strong respect with governmental entities and law enforcement agencies on insurance fraud issues.• Creates and orchestrates Skype training programs annually outlining investigation tools and techniques used to connect data analytics to develop multi claim projects and handling. Show less Responsible for the review, analysis and expertise of policies in all states to determine coverage availability. Developed, managed and evaluated fast track claims for purposes of settlement and closings.• Acquired multi-state licensing for the investigation and evaluations of automobile claims in several states including but not limited to New Jersey, New York and Pennsylvania, Florida, Texas, Mississippi, Georgia, Alabama and Colorado.• Completed multiple detailed recorded statements from potential litigants and witnesses in preparation of settlement of claims or future litigation.• Developed all phases of trial preparation, including directing investigations, obtaining statements from potential witnesses and litigants, working with defense counsel regarding trial strategies and providing trial testimony as necessary.• Partnered with local, state and federal law enforcement agencies in the procurement of sworn statements from witnesses and litigants as well as the collection of all evidence necessary for litigation and criminal prosecution of organized crime rings. Resulted in multi-million dollar identification and prosecution of claims related to personal injury, property damage and medical fraud. Show less

  • Sr. Claim Specialist SIU/MCIU

    Jun 1987 - Jul 2018

  • Sr. Claims Investigator SIU

    Jan 1987 - Jul 2018

  • Sr. Claims Investigator SIU

    Jan 1987 - Jan 2014
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  National general insurance

  May 2019 - Feb 2021

  Special investigator
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  Jerry rickelmann d/b/a private investigator

  Nov 2020 - now

  New jersey state licensed private investigator

  PI

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  Mercury insurance

  Feb 2021 - now

  Special investigator ii