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#21-003272-0001
Supplemental Questionnaire

Last Name
First Name

 

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.***


1.

Do yo have three years of experience must be specifically in adjusting auto, property, casualty and/or general liability multi-line claims.?  If yes, please list employer(s) names and dates of experience.  If you do not have this experience, indicate N/A.

2.

Describe your experience dealing with multi-line insurance claims (e.g., first/third party, general liability, property, casualty, bodily injury, etc.).  Experience in the health insurance industry is not applicable as this position does not deal with health or workers' compensation claims.  Please include dates and employer(s) names.  If you do not have this experience, indicate "N/A."

3.

Describe your experience with subrogation in insurance claims handling.  List employer(s) names and dates of experience.  If you do not have this experience, indicate N/A.

4.

Describe your experience with self-insurance and/or commercial insurance.  Provide employers' names and dates of employment.  If you do not have this experience, indicate N/A.

5.

Describe your experience with Microsoft Dynamics 365 or other insurance CRM / ERP applications.  If you do not have this experience, indicate N/A.


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