SWA – Application – SWA Claims Management Services LLC

Phone: 866-337-0112

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Application

"*" indicates required fields

Step 1 of 26

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

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 you are about to provide (Social Security Number, Banking info, Documents, etc.) will be handled securely. These 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. ID Photograph (used for badges). You will need to follow these guidelines.
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 save your application and continue later using the "Save and Continue Later" button, once submitted, any missing or invalid information may result in your application being rejected, at which point you would need to do it over. 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 adjusterservices@swaclaims.com, noting the nature of the problem you encountered and any error message(s) you received. *** Please note that applications are not accepted by email ***

If you have submitted paperwork to SWA Claims in the past, you should not submit an application as it will be rejected. Instead, please send an e-mail to adjusterservices@swaclaims.com to inquire/update your status on our roster.

Equal Opportunity Disclaimer

All qualified applicants will receive consideration for deployment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, among other things, or status as qualified individual with disability.

Notice to Applicants: The following matters will generally restrict an applicant from deployment with SWA Claims Management Services LLC. (this is not an exclusive list): Any conviction involving breach of trust (lying, cheating, stealing, etc.), any conviction involving violence, any conviction for bad checks or other evidence of mishandling of money or finances, any conviction of a felony, any pending felony charges, any outstanding warrant(s), or lack of valid driver's license.

Please note: All deployments are temporary in nature & compensation is determined by event.

Agree to EEO disclaimer and proceed*

I have read the above equal opportunity disclaimer and wish to proceed with the application.*

General Information

Full Legal Name*

First Middle Last Suffix

For the suffix, use Jr., Sr., I, II, III, IV, V, VI, etc.

I do not have a middle name.*

I do not have a middle name.

Maiden/Alias

First name you wish to be addressed as

Driver's License Number

Driver's License State / Territory / Province*

Drivers License Expiration Date*

Month

Day

Year

How did you hear about us?*

Website/Search Engine

Referral

Other

Name of person who referred you:*

Contact Information

Your primary phone number will be used when we need to reach you via phone. The alternate / secondary phone number will only be used if we cannot reach you with your primary number. The public phone number is what we would give to clients and the general public if the need arises in place of your primary number.

Primary Phone Number*

Type*

Cell

Home

Alternate Phone Number

Type*

Cell

Home

Public Phone (used with clients/public)

Type*

Cell

Home

SWA Claims Management Service may use text messaging as a method of rapidly communicating with our team. By providing your cell phone number and answering "Yes" to text messaging, you consent to receive text message from SWA Claims Management Services, LLC. for purposes related to our services. Message frequency may vary. Message and data rates may apply. Reply HELP for help or STOP to unsubscribe. Your mobile data will not be shared with third parties.

Opt-In Text Messaging*

Yes

SWA Claims Management Service uses email extensively to communicate with you. The primary email address you give below will be used to send information. The alternate / secondary email will only be used if we cannot reach you with your primary address.

Primary Email Address*

Enter Email Confirm Email

Alternate / Secondary Email Address

Enter Email Confirm Email

Please double check that your e-mail addresses are accurate before continuing, and be sure to "whitelist" swaclaims.com in your software.

Address / Mailing Information

Physical Address (No P.O. Boxes)*

City*

County*

State / Territory / Province*

Zip Code*

Country*

Mailing Address Same

Mailing Address is the same as Physical Address

Mailing Address*

City*

County*

State / Territory / Provience*

Zip Code*

Country*

Emergency Contact Information

ER Contact Name #1*

Relationship*

Phone Number 1*

Phone Number 2

ER Contact Name #2

Relationship

Phone Number 1

Phone Number 2

Areas of Interest

Area of Interest*

Appraiser

Auto Adjuster

Desk Adjuster

File Examiner

Fire Investigator

Flood Adjuster

Marine Adjuster

Property Field Adjuster - Catastrophe

Property Field Adjuster - Daily

Umpire

Questions for Appraiser

What year did you become an Appraiser?*

For the following types of coverage, how many claims have you appraised?

Auto*

Property*

Are you a certified appraiser?*

Yes

Appraiser certification date*

Month

Day

Year

Copy of appraiser certificate*

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

Questions for Auto Adjuster

What year did you become an Auto adjuster?*

For the following types of coverage, how many claims have you written or estimated?

Commercial Auto:*

Farm Equipment:*

Heavy Equipment:*

Personal Auto:*

RV:*

How many claims have your worked in the following auto adjuster positions?

Desk Auto Onsite & Remote:*

Field Drive Thru:*

Field Inspection:*

Of those claims, which of the following types of damage do you have experience with?

Area of Interest*

Collision

Flood

Hail

Total Loss

Wind/Hurricane/Tornado

Questions for Desk Adjuster

What year did you become an Desk adjuster?*

Are you interested in remote positions?*

Yes

Are you interested in on-site positions?*

Yes

Of the following types of coverage, how many claims have you processed and settled?

Aircraft:*

Business Interruption:*

Commercial - Large (>= $500,000):*

Commercial - Small (< $500,000):*

Commercial (Contents)*

Farm & Farm Equipment:*

Heavy Equipment*

Marine:*

Personal Property (Contents):*

Residential:*

Of the following perils, how many claims have you processed and settled?

Attorney/PA*

Builders Risk*

Fire*

Hail*

Hurricane*

Liability*

Structural Damage*

Theft*

Tornado*

Vandalism*

Water Damage (Pipe breaks)*

Wind*

Questions for File Examiner

What year did you become a File Examiner?*

What is the largest claim you have reviewed?*

Are you interested in remote positions?*

Yes

Are you interested in on-site positions?*

Yes

Of the following types of coverage, how many claims have you reviewed?

Aircraft:*

Business Interruption:*

Commercial - Small (< $500,000):*

Commercial - Large (>= $500,000):*

Commercial (Contents)*

Farm & Farm Equipment:*

Heavy Equipment*

Marine:*

Personal Property (Contents):*

Residential:*

Of the following perils, how many claims have you reviewed?

Builders Risk*

Fire*

Hail*

Hurricane*

Liability*

Structural Damage*

Theft*

Tornado*

Vandalism*

Water Damage (Pipe breaks)*

Wind*

Questions for Fire Investigator

Do you have cause and origin experience?*

Yes

What year did you become a Fire Investigator?*

Do you hold a fire investigators certification license?*

Yes

Fire Certification Date*

Month

Day

Year

Copy of fire certificate*

Accepted file types: doc, docx, jpg, jpeg, heic, png, pdf, Max. file size: 25 MB.

Questions for Flood Adjuster - Catastrophe

What year did you become a Flood Adjuster?*

What is the largest claim you have written?*

Do you have a FCN (Flood Certification Number)?*

Yes

Please give your flood certification number:*

Flood Certification Date*

Month

Day

Year

Copy of flood certificate*

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

Flood areas*

Residential

Manufactured (Mobile) Home / Travel Trailer

Small Commercial

Large Commercial

Condominium (RCBAP)

Of the following types of coverage, how many claims have you written or estimated as an Outside Flood Adjuster?

Commercial - Large (>= $500,000):*

Commercial - Small (< $500,000):*

Manufactured:*

RCBAP:*

Residential:*

Of the following types of coverage, how many claims have you written or estimated as an Inside Flood Adjuster?

Commercial - Large (>= $500,000):*

Commercial - Small (< $500,000):*

Manufactured:*

RCBAP:*

Residential:*

Questions for Marine Adjuster

What year did you become a Marine Adjuster?*

Of the following types of coverage, how many claims have you written or estimated?

Under 25 ft*

Over 25ft*

Questions for Property Field Adjuster - Catastrophe

What year did you become a Property Field CAT Adjuster?*

What is the largest claim you have written?*

Of the following types of coverage, how many claims have you written or estimated?

Aircraft:*

Business Interruption:*

Commercial - Large (>= $500,000):*

Commercial - Small (< $500,000):*

Commercial Property (Contents):*

Farm & Farm Equipment:*

Heavy Equipment:*

Marine:*

Personal Property (Contents):*

Residential:*

Of the following perils, how many claims have you written or estimated?

Builders Risk*

Fire*

Hail*

Hurricane*

Liability*

Structural Damage*

Theft*

Tornado*

Vandalism*

Water Damage (Pipe breaks)*

Wind*

Questions for Property Field Adjuster - Daily

What year did you become a Property Field Daily Adjuster?*

What radius are you willing to travel (miles)?*

Of the following types of coverage, how many claims have you written or estimated?

Air Craft:*

Business Interruption:*

Commercial - Large (>= $500,000):*

Commercial - Small (< $500,000)*

Commercial Property (Contents):*

Farm & Farm Equipment*

Heavy Equipment*

Marine*

Personal Property (Contents):*

Residential:*

Of the following perils, how many claims have you written or estimated?

Builders Risk*

Fire*

Hail*

Liability*

Theft*

Vandalism*

Water Damage (Pipes)*

Wind*

Questions for Umpire

What year did you become an umpire?*

Of the following types of coverage, how many instances have you done?

Auto*

Property*

Are you a certified umpire?*

Yes

Umpire certification date*

Month

Day

Year

Copy of umpire certificate*

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

Carrier Certifications

Untitled

Certification	Date of Certification	Expiration Date	Actions

There are no Certifications.

Maximum number of certifications reached.

Non-Carrier Certifications

Untitled

Certification	Date of Certification	Expiration Date	Actions

There are no Certifications.

Maximum number of certifications reached.

Other Qualifications / Experience

Untitled

Other Qualification / Experience	Number of Years	Actions

There are no Entries.

Maximum number of entries reached.

Languages / Software

Choose any languages you are fluent in besides English:

(click the "+" to add additional languages. Use "-" to remove them)

Choose any software that you are proficient with:

(Click the "+" to add additional software. Use "-" to remove them)

Xactnet Address:

Education & Military

Highest level of education completed:*

Are you a Veteran?*

(served in the military, naval, or air service, and was discharged or released under conditions other than dishonorable)

Yes

Are you retired Military?*

(served a minimum of twenty years in the military, naval, or air service)

Yes

Have you served as a first responder?*

Yes

License Information

Do you have a passport?*

Yes

Expiration Date*

Month

Day

Year

Copy of Passport*

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

Do you hold a valid adjusting license?*

Yes

Please list below any adjuster license(s) you presently have.

State / Territory / Province	Adjusting License Number	Issue Date	Actions

There are no Licenses.

Maximum number of licenses reached.

Do you hold an adjusters license in your home state?*

Yes

Not Required

Do you hold a public adjusters license?*

Yes

Please list below any public adjuster license(s) you presently have.

State / Territory / Province	Public Adjusting License Number	Issue Date	Actions

There are no Licenses.

Maximum number of licenses reached.

Please give your National Producer Number (NPN):

Have you ever had any adjuster license suspended or revoked?*

Yes

Indicate state/territory/province where a license was revoked:*

Do you carry your own Errors & Omission’s coverage?*

Yes

E&O Policy Number

E&O Policy Effective Date*

Month

Day

Year

E&O Policy Expiration Date*

Month

Day

Year

E&O Policy Limit*

Copy E&O Coverage*

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

W9 Form

If you need assistance on how to fill the W9 form, please follow this link, which has instructions for how to fill out the W9 information.

Box 1 Name of entity/individual*

Box 2 Business name/disregarded entity name

Box 3a Check the appropriate box for federal tax classification.*

Individual/Sole proprietor

C Corporation

S Corporation

Partnership

Trust/Estate

Limited Liability Company

Other

Tax classification code*

Box 3b - Foreign partners

Box 4 Exempt payee code (optional)
Codes apply only to certain entities, not individuals.

Box 4 Exemption from FATCA reporting code (optional)

Box 5 Address

Box 6 City

Box 6 State / Territory / Province

Box 6 Zip Code

Box 7 List account number(s) (optional)

Part 1 - Social Security Number*

Part 1 - EIN*

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.
----------- END OF TEXT -----------
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 (including contract for services) with SWA Claims Management Services, LLC., I understand that investigative background inquires are to be made on myself including consumer, criminal, driving, and other reports. These reports will include information as to my 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 you will be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my driving, credit, civil, and other experiences as well as claims involving me in the files of insurance companies. I agree that a facsimile, electronic, or photographic copy of this authorization to be as valid as the original. I authorize, without reservation, any party or agency contacted to furnish the above mentioned information:

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

Sterling Infosystems, Inc.
1 State Street
New York, NY 10004
877-424-2457

----------- END OF TEXT -----------

California, Massachusetts, Minnesota, New Jersey & Oklahoma Applications Only: Please check the box below if you would like a copy of your consumer report sent directly to you by Sterling Infosystems, Inc. to your mailing address
Request for copy of consumer report
I wish to receive a copy of my consumer report.
Under section 1786.22 of the California Civil Code, you have the right to request AISS, upon identification, the nature and substance of all information in its files on you, including sources of information, and the recipients of any reports on you which AISS has previously furnished within the two-year period preceding your request. You may view the file maintained on you by AISS during normal business hours. You may also obtain a copy of this file upon submitting proper identification and paying the cost of duplication services. Upon making a written request, you may receive a summary of your report via telephone.

Document Upload
Please submit the following documents.
Note: Please upload files with unique filenames.
Drivers License*
Accepted file types: jpg, jpeg, heic, png, pdf, tiff, Max. file size: 25 MB.
Self-Portrait Photograph (used for badges)*
Accepted file types: jpg, jpeg, heic, png, tiff, Max. file size: 25 MB.
Please follow these guidelines Do NOT submit a copy of your drivers license.
Resume*
Accepted file types: doc, docx, pdf, Max. file size: 25 MB.

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.