Senior Workers’ Compensation Claims Advocate
Designations: WCCP, SIP
James is responsible for working with employers and claims administrators to facilitate prompt resolution of Workers’ Compensation claims and reduce costs. He develops litigation strategies with clients and defense attorneys on how to maneuver claims through the litigation process. He educates his accounts about how to manage their claims with best practices to positively impact the trends and outcomes of current and future claim costs.
James has over 20 years of experience in California Workers Compensation Claims. He has worked for both Insurance Carriers and Third Party Administrators as a Claims Examiner and Supervisor. He is an ex US Air Force PJ (Special Forces/Search and Rescue). His expertise in emergency medicine assists in prompt and accurate diagnosis, appropriate medical treatment, proper reserving and guidance in return to work. He has personally worked with local orthopedics and has knowledge of many of their qualifications. He has worked with both large and small employers to assist them with managing their claims. He is effective with identifying key issues on claims to promptly bring them to resolution to reduce claim costs and protracted litigation.
Specific Areas of Expertise
Identifying areas for subrogation potential and recovery
Analyze reserves to ensure they reflect exposure based on case facts to claim resolution
AOE/COE Affirmative Defenses
Provide tactics to reduce costs in creative apportionment, joining other carriers to participate in costs, and other analytical strategies.
Identifying settlement opportunities with emphasis for creative nontraditional tactics for prompt resolution
Litigation strategy management
Identifying and recommending appropriate vendors to mitigate costs
Developing strategies to move claims to resolution and closure
Extensive experience in emergency medicine, orthopedics and radiology.
Professional Accolades & Memberships:
WCCP - Workers’ Compensation Claims Professional
SIP – Self-Insurance Certificate
CCA – California Certified Adjuster
Hobbies & Interests:
Anything outdoors. Backpacking, hunting, fishing, skiing and boating. Wine tasting, going to movies, working out and sushi!