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Insurance Claim Adjuster/Examiner

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AVG. SALARY

$68,760

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EDUCATION

High school (GED) +

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JOB OUTLOOK

Decreasing

What They Do

Claims Adjusters, Examiners, and Investigators Career Video

About This Career

Reviews settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confers with legal counsel on claims requiring litigation. May also settle insurance claims.

This career is part of the Finance cluster Insurance pathway.

A person in this career:

  • Examines claims forms and other records to determine insurance coverage.
  • Analyzes information gathered by investigation and reports findings and recommendations.
  • Pays and processes claims within designated authority level.
  • Investigates, evaluates, and settles claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
  • Verifies and analyzes data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
  • Reviews police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
  • Investigates and assesses damage to property and creates or reviews property damage estimates.
  • Interviews or corresponds with agents and claimants to correct errors or omissions and to investigate questionable claims.
  • Interviews or corresponds with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
  • Enters claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

Working Conditions and Physical Demands

People who do this job report that:

  • You would sit most of the time. There's some walking and standing. You may have to lift and carry things like books, papers or tools weighing 10 lbs. or less.
  • Work in this occupation requires being inside most of the time
  • Work in this occupation involves sitting more than one-third of the time

Working in this career involves (physical activities):

  • Seeing clearly up close
  • Speaking clearly enough to be able to be understood by others
  • Identifying and understanding the speech of another person

Work Hours and Travel

  • Irregular hours
  • Overnight travel

Specialty and Similar Careers

Careers that are more detailed or close to this career:

  • Field Claims Adjuster
  • Claims Adjuster — Investigates insurance claims in order to determine if the policy will cover the damages that are being claimed and to determine if the claim is legitimate.
  • Claims Analyst
  • Claims Examiner
  • Claims Representative
  • Claims Specialist
  • General Adjuster
  • Litigation Claims Representative
  • Home Office Claims Specialist
  • Corporate Claims Examiner

Contact

  • Email Support

  • 1-800-GO-TO-XAP (1-800-468-6927)
    From outside the U.S., please call +1 (424) 750-3900

Support


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OCAP believes that financial literacy and understanding the financial aid process are critical aspects of college planning and student success. OCAP staff who work with students, parents, educators and community partners in the areas of personal finance education, state and federal financial aid, and student loan management do not provide financial, investment, legal, and/or tax advice. This website and all information provided is for general educational purposes only, and is not intended to be construed as financial, investment, legal, and/or tax advice.