SWA – Adjuster Application – SWA Claims Management Services LLC

Adjuster Application

"*" indicates required fields

Step 1 of 27

Thank you for your interest in joining SWA Claims Management Services, LLC!

If you have submitted paperwork to SWA Claims in the past, you should not submit an application as it will be rejected. If unsure as to your status on our roster, please send an e-mail to [email protected] to inquire about your status.

The first step in joining our team is to be added to our roster by completing our online application. Required fields are marked with an * (asterisk). Please use the next / previous buttons at the bottom of each page. Do not use your browser forward / back buttons. After your credentials have been verified by our recruiting department, you will be added to our roster.

The information and documents you are about to provide (Social Security Number, Banking info, Licenses, etc.) will be handled securely. The information and documents are required for SWA Claims Management Services recruiting purposes.

Before you begin the application, please make sure you have a copy of the following items completed & saved for uploading during the application process:

1. Copy of your driver's license.
2. Copy of your adjusters license for your home state or designated home state.
3. An ID Photograph (used for badges). You MUST follow these guidelines https://services.swaclaims.com/photo-id. A picture of your drivers license is not acceptable as it cannot be used for badges.
4. Copy of your resume.

You will not be able to complete and submit your application without the required information.

Please fill out all information completely and accurately as possible. While you can stop and continue later, once submitted, any missing or invalid information, may result in your application being rejected, at which point you would need to do it over.

Missing, inaccurate, or information not given as requested, or an invalid photo ID, may also delay or stop you from being considered for potential deployments.

The application will take approximately thirty minutes if you have all the required information available. File uploads are limited to 25MB in size.

If you have a problem completing this application online, please send an email to [email protected], noting the nature of the problem you encountered and any error message(s) you received.

*** Please note that applications are not accepted by email ***

Certification	Date of Certification	Expiration Date	Actions

There are no Certifications.

Certification:	Date of Certification:	Expiration Date:	Actions

There are no Certifications.

Other Qualification / Experience	Number of Years	Actions

There are no Entries.

Direct Deposit Authorization
Consent for Direct Deposit*
I authorize direct deposit to / from my account

I authorize SWA Claims Management Services, LLC. to initiate automatic deposits to my account at the financial institution named below. In the event that SWA Claims Management Services, LLC. deposits funds erroneously into my account, I authorize SWA Claims Management Services, LLC. to debit my account for an amount not to exceed the original amount of the erroneous credit.

This agreement will remain in effect until SWA Claims Management Services, LLC. receives a written notice of cancellation from me.
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Name(s) on Account*
Name of Financial Institution*
City*
State / Territory / Province*
Routing Number (must be nine digits)*
Must be 9 digits.
Confirm Routing Number (must be nine digits)*
Must be 9 digits.
Account Number*
Confirm Account Number*
Account Type*

Checking

Savings

Disclosure Statement
Pursuant to the Violent Crime Control and Law Enforcement Act of 1994, 18 U.S.C. §1033(e), an individual may not engage in the business of insurance if the individual has been convicted of a felony involving dishonesty or breach of trust, unless the individual has the written consent of an appropriate insurance regulatory official. SWA Claims Management Services LLC will be conducting a background check to verify the information provided.
Have you ever been convicted of a felony?*

Yes

No
Date of Conviction*
Month
Day
Year

Court*
City*
State / Territory / Province*
Describe in detail the conviction and criminal act:*
Type of punishment or penalty received as a result of the conviction:*

Inquiry Release
Date of Birth*
Month
Day
Year

SSN*
Confirm SSN*
Your Date of Birth and Social Security Number are being requested to insure the accurate retrieval of records.
Consent to inquiry release*
I hereby consent to the inquiry release as stated below.

In connection with and for the duration of my employment and / or contract services with SWA Claims Management Services, LLC., I understand that investigative background inquires may be made on myself from a third-party consumer reporting agency for employment and / or contract services. These reports may include information to my, but not limited to, general reputation, character, mode of living, work habits, performance, and experience along with reasons for termination of past employment from previous employers.

Further, I understand that SWA Claims Management Services, LLC. may request information from various federal, state, and other agencies which maintain records concerning my past activities relating to my, but not limited to, motor vehicle ("driving records"), credit, civil, criminal, education, employment, and other experiences histories, as well as claims involving me in the files of insurance companies.

I authorize, without reservation, any party or agency contacted to furnish the above-mentioned information.

I have read and understood the Federal Fair Credit Report Act (FCRA) , which is found HERE.

I agree that a facsimile, electronic, or photographic copy of this authorization to be as valid as the original.

This information will, in total or in part, be obtained from:

Checkr, Inc.
One Montgomery Street
Suite 2400
San Francisco, CA 94104
(844) 824-3257

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Additional Inquiry Release Notices:

Note to California residents:
The source of any investigative consumer report (as that term is defined under California law) will be:

Checkr, Inc. One Montgomery Street Suite 2400 San Francisco, CA 94104 (844) 824-3257

Under California Civil Code section 1786.22 of the California Civil Code, you are also entitled to find out what is in the consumer reporting agency’s file on you with proper identification, as follows:

1. In person, by visual inspection of your file during normal business hours and on reasonable notice. You may also request a copy of the information in person. The CRA may not charge you more than the actual copying costs for providing you with a copy of the file.

2. A summary of all the information contained in the CRA file on you that is required to be provided by the California Civil Code will be provided to you via telephone, if you have made a written request, with proper identification, for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to you.

3. By requesting a copy be sent to a specified addressee by certified mail. CRAs complying with requests for certified mailings shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the CRAs.

“Proper Identification” includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the CRA require additional information concerning your employment and personal or family history in order to verify your identity.

The CRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in the files maintained on you. This written explanation will be provided whenever a a file is provided to you for visual inspection. You may be accompanied by one other person of your choosing, who must furnish reasonable identification. A CRA may require you to furnish a written statement granting permission to the CRA to discuss your file in such person’s presence.

Note to California residents - Fair Chance Act:
Please click HERE for information on the California Fair Chance Act.

Note to Los Angeles Candidates only:
Please click HERE for the Los Angeles Notice to Candidates and Employees for Private Employers.

Note to San Francisco candidates only:
Please click HERE for the City & County of San Francisco Fair Chance Ordinance.

Note to New York residents / candidates:
Upon request, you will be informed whether or not a consumer report was requested by SWA Claims Management, LLC., and if such report was requested, informed of the name and address of the consumer reporting agency that furnished the report. You have the right to inspect and receive a copy of any investigative consumer report requested by SWA Claims Management LLC, by contacting the consumer reporting agency identified above directly. By consenting above, you acknowledge receipt of Article 23-A of the New York Correction Law. To view Article 23-A, click HERE and click on "Correction Law Article 23-A"

Note to New York City residents / candidates:
You acknowledge and authorize SWA Claims Management, LLC, to provide any notices required by federal, state, or local law to you at the address(es) and/or email address(es) you provided to SWA Claims Management Services, LLC.

Note to Washington State candidates:
You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.

Request for copy of consumer report:
For California, Massachusetts, Minnesota, New Jersey And Oklahoma Applications Only - Please check the box below if you would like a copy of your consumer report.
Request for copy of consumer report
I wish to receive a copy of my consumer report.

Document Upload
Please submit the following documents.
Copy of Drivers License:*

Drop files here or

Accepted file types: jpg, jpeg, heic, png, pdf, tiff, Max. file size: 25 MB, Max. files: 1.

Licenses List:

Drop files here or

Accepted file types: csv, doc, docx, jpg, jpeg, heic, png, pdf, tiff, xls, xlsx, Max. file size: 25 MB, Max. files: 1.

If you upload a license list here (you did not upload individual licenses in the license section), it must include the state, license type, license number, and expiration date for each license.

Self-Portrait Photograph (used for badges):*

Drop files here or

Accepted file types: jpg, jpeg, heic, png, tiff, Max. file size: 25 MB, Max. files: 1.

You need to follow these guidelines https://services.swaclaims.com/photo-id. when submitting your photo.

*** Do NOT submit a copy of your drivers license as it is unuseable for your badge. ***

Resume:*

Drop files here or

Accepted file types: doc, docx, pdf, Max. file size: 25 MB, Max. files: 1.

Declarations and Submittal
Certification of information provided*
I certify the information I have provided to be true to the best of my knowledge.

Agree to Terms and Conditions*
I have read and agree to the Terms & Conditions.

Adjuster Application

Equal Opportunity Disclaimer

General Information

Contact Information

Address / Mailing Information

Emergency Contact Information

Areas of Interest (check all areas that apply)

Questions for Appraiser

Questions for Auto Adjuster

Questions for Clerical / Admin

Questions for Desk Adjuster

Questions for Field Adjuster - Catastrophe

Questions for Field Adjuster - Daily

Questions for Field Adjuster - Flood

Questions for File Reviewer

Questions for Fire Investigator

Questions for Marine Adjuster

Questions for Umpire

Carrier Certifications

Other Certifications

Other Qualifications / Experience

Languages / Software

Education & Military

License Information

W9 Form

Direct Deposit Authorization

Disclosure Statement

Inquiry Release

Document Upload

Declarations and Submittal