Lynette Martinez-Leon Email & Phone Number

Tampa/St. Petersburg, Florida Area

Prompt investigation of all assigned claims with minimal supervision including those of a more complex nature. Determine coverage, compensability, potential for subrogation, and identity of fraudulent claim activities. Ensure timely payment and /or denial of benefits in accordance with jurisdictional requirements. Establish and set appropriate reserves while monitoring for change in exposures during the life of the claim. Work closely with in house and field nurses to execute a return to work strategy. Authorize medical treatment based on medical necessity. Communicate effectively with all parties while maintain knowledge of jurisdictional requirements and applicable case law for each state.

Tampa/St. Petersburg, Florida Area

Determine compensability, plan of action, negotiation, and claim resolution for all Gallagher Bassett claims. Ensure timely of medical benefits are issued per FL state guidelines. Complete a thorough investigation and rule out any fraud issues or concerns. Monitor medical treatment and negotiation. Communicate effectively with all parties involved until the claim is either closed or forwarded to a Lost Time adjuster.

Tampa/St. Petersburg, Florida Area

Perform initial investigation personal auto property damage. Evaluate insurance coverage based on claim report.Obtain recorded statements, pictures, and witness statements for interview purposes. Review medical records and property damage for potential benefits or exposures.Add reserves appropriately to cover conservative treatment plan or property damage.Determine compensability, plan of action, set reserves, set up property appraisals.Issue PD benefits according to appraisal and field adjuster PD evaluation. Determine if any fraud potential to forward to SIU department.