PLRB 2021 Outstanding Claims Professional Award

The PLRB Large Loss Conference was recently held in Tampa with over 600 attendees, and wellness protocols in place.  We were excited to meet in person with so many claims and service professionals.

Three Outstanding Claims Professionals were honored at the general session for their exemplary claims service to policyholders, claimants, and our communities. 

It is our privilege to announce that the following (listed in alphabetical order) are the three recipients of PLRB's 2021 Outstanding Claims Professional Awards:

  • ADAM GOERGES - Great American Insurance Group
  • CHRIS HALL - Amica Mutual Insurance Company
  • JAVIER MATUS - Citizens Property Insurance Company

These three individuals are truly deserving of recognition and have made great contributions not only to their employer but through their stellar service, they have also helped the claims industry as a whole. We encourage claims professionals reading this article to read about Adam, Chris and Javier for ideas on how to excel as a claims professional. Congratulations Adam, Chris and Javier!

 

ADAM GOERGES - Great American Insurance Group

Adam Goerges is a Senior Field Claims Specialist for Great American Insurance Group - Alternative Markets Division. Adam is a lead adjuster and a true subject matter expert on insurance coverage and property claim fundamentals. Adam has 20 years of claims experience as a multi-line claim professional, specializing in property claims over the last 7 years. Adam is a claim professional and challenges himself to become an expert on the subject matter within the scope of his position.

Willingness to Volunteer and Desire to Learn

Early in his professional journey, Adam volunteered for CAT Duty and was on several CAT Teams which identified for him a need to become a roof and structure expert. Adam aligned with a local engineering firm and developed a skill set in the basics of construction securing the Haag Certified Roof Inspector credential. His passion to become an expert is tempered with a common sense and personalized approach to claims handling that makes Adam a one-of-a-kind asset to Great American's division.

His employer's Alternative Markets Division specializes in Captive Programs which creates a frequency of claims in the same niche industries. One of his employer's largest programs is a Winery Program that is a National Market leader in specialized winery coverage throughout the country with a concentration of risks in California. Wildfires over the last several years have been a large challenge for this program, creating significant large losses to wineries in California. In response to these events, starting with the 2017 wildfire event, Great American changed its independent adjuster response model and felt it was most important to have its staff respond with boots on the ground. It developed an action plan designed to have a staff adjuster on site to respond to its clients at their greatest time of need. Adam volunteered to spearhead this initiative and deployed to Napa while the fires were still burning in the mountain side, armed with a list of local resources, a folder of over 30 very large and catastrophic claims and a check book. Adam engaged a local independent adjuster for support and created a field response office in California that he led which eventually handled over 120 wildfire CAT claims with over 60 days spent in the field.

Specialized Service Leads to Market Growth

This experience caused local agents to praise Great American for delivering "specialized" claim service. Adam's response helped lead Great American to amazing growth after this event on referral business within the industry. This experience also helped Great American realize that it had to continue to develop its winery expertise. This was a natural development for Adam and expanding on the relationships he made in the 2017 CAT response, Adam made several trips back to Napa to spend time with local wine makers and experts to further learn the industry.

This experience was replicated in future events in 2018 and 2020. Adam continued to spear head his employer's CAT Response to these events, issuing significant advances, and collaborating with insureds to develop creative recovery plans for larger losses. Adam was able to call on relationships to partner with insureds and find capacity for wine storage and resource sharing to minimize loss for several insureds. Adam's acquired knowledge of the wine industry allowed him to collaborate with underwriting to identify and address very complex issues, including post-CAT construction inflation. During the off-wildfire season, Adam partnered with underwriting and conducted field inspections of the largest risks with local agents and brokers. Utilizing state-of-the art tools, such as drones and advanced software to confirm the insurance value on several of his employer's largest risks that had vineyards and structures throughout several hundred owned acres, Adam's efforts led to more accurate underwriting of the risks. This program was unprecedented in the industry in the it involved the claims department insured-to-value review, and was embraced by insureds and agents alike to provide stability to the proper coverage and rates for the specific risks.

Provides Training and Embraces Technology

Adam currently leads Great American's Property Complex Claims team. He continues to manage its largest losses and deploys frequently as a one-person CAT team. He is also working to develop a training program for his team to utilize his experience and create a customized curriculum to continue an approach of specialized claim management. One of the best parts of Adam's curriculum is the balance of embracing technology to maximize modern tools, while focusing on the need to develop personal relationships and display emotional intelligence to support insureds emotionally after experiencing traumatic large losses.

High Customer Satisfaction

His employer has commented that "it is very difficult to measure the value Adam adds to our bottom line." Adam's expertise and commitment to boots on the ground response saves significant vendor cost. The prompt response and expertise allow for clear development of restoration plans, and his local network creates an access to resources that reduce periods of restoration and shortens claim life. The insured-to-value project has resulted in more accurate premium dollars. His employer's policy retention is incredibly high and its property team's customer survey responses indicate a satisfaction level over 98%. Overall, from any benchmark, Adam Goerges is a claims leader across the industry and delivers results and relationships beyond expectations. Adam is a valuable asset to his employer and a well-deserving recipient of the 2021 Outstanding Claim Professional Award. Congratulations, Adam!

Next, I want to highlight the great efforts of Chris Hall of Amica Mutual Insurance Company. Chris is a Senior Claims Adjuster with Amica Mutual Insurance Company. She is described by others as "an invaluable asset and an unbelievably hard working member of the Amica claims team."

CHRIS HALL - Amica Mutual Group

Next, I want to highlight the great efforts of Chris Hall of Amica Mutual Insurance Company. Chris is a Senior Claims Adjuster with Amica Mutual Insurance Company. She is described by others as "an invaluable asset and an unbelievably hard working member of the Amica claims team."

Great Customer Rapport and Work Ethic

Chris is well respected by both her colleagues and her customers. Because of this, insureds who have previously worked with her often ask that she be assigned to their subsequent losses. Chris has an uncanny ability to relate exceptionally well with insureds and claimants alike. Answering emails and phone calls before and after hours, on weekends and holidays is the norm for her.

Outstanding Customer Service

Chris's work ethic is only surpassed by her unmatched customer service skills. Her greatest asset is her never-ending desire to provide the best possible customer service on each and every one of her claims. She consistently goes out of her way to make each and every customer feel like they are her only concern. Examples include her bringing flowers to a customer following a devastating fire loss at their home or fresh baked cookies as a parting gift after working closely with a customer over several months.

Many of the customers Chris interacts with proactively reach out to her Supervisor and Manager to express their appreciation for the work that Chris put forth on their claim. Words used to describe Chris include "patient," "calm," "helpful," "an asset to Amica", "warmth" and "sincerity."

Chris's empathetic approach to claims handling was on display during California 2020's active fire season. In one particular file, she spent countless hours working with an Amica customer who had lost all of his personal belongs. She developed and priced the large inventory of lost unscheduled personal property.

Training and Mentoring

In addition to her external customer service skills, she also assists with the training and mentoring of new adjusters. She takes time out of her schedule to accompany her newly hired peers on loss inspections and works with them through the estimating process. Chris's supervisor describes Chris has as "the mold that all Amica adjusters strive to achieve!" Chris is truly deserving of PLRB's Outstanding Claims Professional Award. Congratulations, Chris!

 

JAVIER MATUS Citizens Property Insurance Company

Finally, we focus on Javier Matus, who is a Mediation Specialist for Citizens Property Insurance Corporation (CPIC). As an integral part of the mediation team, Javier is primarily responsible for managing contested claims where the insured, or their representative, has requested Department of Financial Services (DFS) mediations. The claims in mediation are mostly represented by an attorney or public adjuster and are disputed claims. Some claims were closed without payment as a full denial and others were claims that were paid, but there is a dispute in price and scope. Javier uses his experience and knowledge to amicably negotiate and settle the majority of his claims in mediation. This avoids the excessive costs and time of litigation.

Relationship Builder

Javier has formed professional relationships with many mediators, public adjusters, and attorneys. In-between his day-to-day mediation assignments, Javier also assists other teams such as the litigation mediation team, the SIU team, and the appraisal team with peer reviews, law and ordinance reviews, and policy/technical reviews. He is always willing to assist when needed. In December 2020, Javier was a recipient of his employer's Superstar award for his work in the mediation team and his assistance with the other teams.

Knowledge Seeker

Throughout his career as a claims professional, Javier has volunteered to be a part of as many different types of claims as possible, including antique auto, jet-ski, mobile home, dwelling, large fire losses, NFIP flood, sinkhole, appraisals, and high urgency claims with attorneys and/or public adjuster representation. Javier takes as many classes and courses as possible to work his way toward becoming the subject matter expert on several topics. Just in the past few years, he has taken the following classes, courses, and certifications:

  • Florida High-Wind Manual Certification
  • Haag Roof Damage Assessment
  • Haag Certified Inspector - Residential Roofs

· PLRB Distance Learning Certification (Including building codes, water backups, progressive losses, commercial roofing losses, etc.)

· IBHS (Insurance Institute for Business and Home Safety) webinars

· Donan Engineering Webinars (Wind & Hail 101, residential kitchen fires, mitigating water losses, commercial roofing, construction defects, etc.)

With his vast amount of education, Javier was asked to create a presentation encompassing law and ordinance, roofs, windows, etc. The hour-long presentation was presented to three different groups at Citizens between 2020 and 2021. Javier received excellent feedback and compliments.

Emerging Leader

Javier has volunteered at local Habitat for Humanity locations. Often, he would bring the new adjusters along to show the different phases of home construction as he felt it was important to visualize how building materials come together to make a home. He would also take the new adjusters to the local home improvement stores to show them the different building materials.

In 2020, Javier was nominated for and chosen to participate in the Emerging Leaders program. This program identifies individual contributors who have the potential to become future leaders at his employer. It is a six-month program where the participants take various assessments, discuss different working styles, communicate, network with current leaders, and are provided with tools to prepare the participants for successful leadership. Javier graduated from this program in December 2020.

Javier continues his personal growth by making himself available to take on any tasks that will increase his experience at Citizens Property Insurance Company. He continuously looks for ways to help his team, build relationships both internally and externally, and has a thirst for knowledge so as to become a great ambassador for his employer. With his never-ending desire to learn, grow, and form relationships, Javier is well deserving of the PLRB Outstanding Claims Professional award. Congratulations, Javier!