Claims Adjusters, Examiners, and Investigators
Claims adjusters review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Insurance claims adjuster confers with legal counsel on claims requiring litigation and may settle insurance claims as well.
A Claims adjuster job is to examine claims forms and other records to determine insurance coverage, analyze information gathered by investigation and report findings and recommendations and review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. Insurance claims adjusters further perform tasks like investigating and assessing property damage, creating or reviewing property damage estimates, and interviewing agents and claimants to correct errors or omissions and investigate questionable claims.
The knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process is must become an insurance claims adjuster, followed by a claims examiner salary. A claims adjuster performs work activities like writing software, setting up functions, entering data, processing information, getting information from all relevant sources, analyzing data, evaluating results to choose the best solution and resolving conflicts, and negotiating with others.
To be successful in the career path of the claims adjuster, complete a four-year degree program and obtain work-related experience. A seven-figure salary can be provided to the insurance claims adjuster contingent on the location and job profiles.
Qualifications
Every career requires an element of study and academic qualification, and there can be several study routes and pathways you can take. In following any academic pathway you will study subjects that contribute to the specialised knowledge required to achieve your career goals. These qualifications provide a future employer with the evidence that you have the desired knowledge, understanding and experience of their industry, so it’s important to consider the various types of qualifications available to you and to understand how they can boost your career and create opportunities for you.
- Bachelor's Any Subject
- ACET Actuarial Common Entrance Test
Tasks
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- 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.
- 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.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
- Resolve complex, severe exposure claims, using high service oriented file handling.
- Pay and process claims within designated authority level.
Progression Routes
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