Consulting Team Member

JOSE L. RIVAS

 

CURRICULUM VITAE

 

 

JOSE L. RIVAS

 

 
Mobile: 770.364.6049 407 Woodruff Crossing
Woodstock, GA 30189
 
Summary:

 

Dynamic claims executive with over 25 years of technical claims and consulting experience. Has worked for a variety of insurers, state DOI’s and consulting firms. Experienced in a wide range of assignments including claims audits, loss portfolio assessment and evaluation, run-off operations, subrogation recovery, reinsurance, property and casualty, health and disability reviews and dispute resolutions.

 

Skills/Areas of Expertise:

 

Claims Management, Claim Reviews and Audits

 

  • Claims reviews and audits – auditing files for reserves, quality and variances. Opine on the reserving adequacy and procedures.
  • Guarantee Association annual audits of claims operation and best practices.
  • Audited run-off claims portfolios of worker’s compensation and construction defect.
  • Participated in several due diligence teams, responsible for the claim reserve analysis and operational effectiveness. Conducted on-site interviews of personnel in order to provide objective operational analysis, a critical component of the due diligence.
  • Audit TPA’s handling of hurricane Katrina and Rita CAT claims.
Consulting

 

  • Highly regarded by Insurance Commissioners; lead examiner on insurer market conduct examinations.
  • Led practice that provided claims management services, reinsurance services, claims auditing and examination services.
  • Developed Workers Compensation and Health Care support operations and Third Party Claims Operation start-up.
  • Member of senior level team that worked with Assistant Deputy Receiver, Department of Insurance responsible for the administration of receiverships.
  • Claims and reinsurance management services to insurers, reinsurers and insurance regulators winding down insurance operations.
  • On-going consulting services to a private insurer’s claim operation focusing on process and handling PIP litigation; oversight of non-standard auto program in run-off.
Reinsurance

 

  • Managed reinsurance programs of companies in liquidation for state DOI.
  • Analysis of reinsurance files and records for treaty compliance audits and reinsurance collections.
Receivership, Liquidation and Solvency

 

  • Served as the member of the senior level team that worked directly with Assistant Deputy Receiver to Department of Insurance responsible for the administration of receiverships.
  • Liquidation, receivership and solvency reviews for state DOI’s and Guarantee Associations.
  • Conducted several reserve reviews of worker’s compensation claims for liquidated companies.
 
Experience:

 

Present: Rivas Company, Inc., Woodstock, GA
President and Consultant
 
06/2001 –
09/2009
Regulatory Technologies, Inc., Dallas, TX & Atlanta, GA
Executive Vice President
 
1998 –
2001
Sun States Insurance Group (Queensway Financial Holdings), Atlanta, GA
Senior Vice President Claims
 
1984 –
1998
Served in progressively responsible claims and risk management positions in for GMAC Insurance Group (Integon), AIG Specialty Auto & Progressive Corporation
 
 
Professional Memberships, Affiliations and Certifications:
 
Member International Association of Insurance Receivers — Designation of Accredited Insurance Receiver (Claims/Guaranty Funds & Reinsurance)
Member Association of Insurance and Reinsurance Run-Off Companies
 
 
Education: University of South Florida
Bachelor of Business Administration
Numerous Industry formal & informal training programs
TeamMate trained and licensed
Bi-lingual Spanish

 

 

 

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