What do claims adjusters, examiners, and investigators do?
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
This describes a U.S. occupation, not a live vacancy. Individual employers may use different titles and requirements.
Job titles to recognize in your search
O*NET reports these titles for this occupation. Compare the responsibilities in each posting before treating titles as equivalent.
- Claims Adjuster
- Claims Analyst
- Claims Examiner
- Claims Representative
- Claims Specialist
- Corporate Claims Examiner
- Field Claims Adjuster
- General Adjuster
Core tasks to compare with a job posting
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- Pay and process claims within designated authority level.
- Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
- Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Investigate and assess damage to property and create or review property damage estimates.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Prepare an application for this occupation
- Check the employer’s requirements, location, schedule and any licenses against your situation.
- Choose two or three tasks above that match the posting and your actual experience.
- Build a resume evidence worksheet using the skills and software relevant to that employer.
- Practice explaining your contribution, decisions and results before an interview.
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