Claims Adjusters, Examiners, and Investigators

The work

Core tasks

1. 01Examine claims forms and other records to determine insurance coverage.
2. 02Analyze information gathered by investigation and report findings and recommendations.
3. 03Pay and process claims within designated authority level.
4. 04Investigate, 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.
5. 05Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
6. 06Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
7. 07Investigate and assess damage to property and create or review property damage estimates.
8. 08Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
9. 09Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
10. 10Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
11. 11Resolve complex, severe exposure claims, using high service oriented file handling.
12. 12Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

Capabilities

Essential skills

Employment outlook

Where the role is heading