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Claims Examiners, Property & Casualty Insurance

Also called: Claims Examiner, Claims Specialist, Claims Adjuster, Claims Representative

What they do:
Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Report overpayments, underpayments, and other irregularities. Confer with legal counsel on claims requiring litigation.
On the job, you would:
  • 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.

Knowledge

Business
  • customer service
  • management
Arts and Humanities
  • English language
Safety and Government
  • law and government

Skills

Basic Skills
  • reading work related information
  • writing things for co-workers or customers
Problem Solving
  • noticing a problem and figuring out the best way to solve it
Social
  • bringing people together to solve differences
  • understanding people's reactions

Abilities

Verbal
  • listen and understand what people say
  • read and understand what is written
Ideas and Logic
  • use rules to solve problems
  • notice when problems happen

Personality

People interested in this work like activities that include data, detail, and regular routines.
They do well at jobs that need:
  • Integrity
  • Dependability
  • Attention to Detail
  • Stress Tolerance
  • Self Control
  • Cooperation

Technology

You might use software like this on the job:

Document management software
  • Agency Management Systems AMS 360
  • BCCORP W5 for Adjusters
Expert system software
  • Axonwave Fraud and Abuse Management System
  • Bill review software
Data base user interface and query software
  • Claims processing administration and management software
  • Fair Isaac Claims Advisor

Education

Education: (rated 4 of 5)
bachelor's degree or
some college
usually needed

Get started on your career:

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Job Outlook

Below Average Outlook
New job opportunities are less likely in the future.
Salary
$59,960
per year, on average
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See more details at O*NET OnLine about claims examiners, property and casualty insurance.