When natural disaster strikes, or a car accident happens, insurance professionals are called in to help start putting the pieces back together. When people have an insurance policy for their health, home, or car, and they become injured or their property is damaged, they make a request —called a claim— for payment to cover their costs. Claims adjusters, appraisers, examiners, and investigators evaluate insurance claims, to decide whether an insurance company must pay a claim, and if so, how much. Appraisers estimate the cost or value of an insured item. Most are auto damage appraisers— they inspect damaged vehicles and estimate the cost of repairs. Adjusters inspect damaged real estate properties and automobiles to determine how much the insurance company should pay for the loss. They gather evidence and report it to examiners. Adjusters negotiate with the policyholder to arrive at a final payment amount for their claim. Claims examiners review claims to ensure guidelines are followed properly. They review health-related claims to determine whether to pay… deny… or refer a claim to an investigator. Insurance investigators handle potentially fraudulent claims or suspected criminal activity such as arson, staged accidents, or unnecessary medical treatments. Claims adjusters, examiners, and investigators spend time in the office, and out in the field to inspect damaged properties. Auto damage appraisers spend much of their time at automotive body shops to estimate repair costs. Entry-level claims adjusters, examiners, and investigators need a high school diploma or equivalent. Auto damage appraisers require either a certificate in the field, or work experience estimating the cost of car repairs.
What they 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.
On the job, you would:
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.
Business
customer service
administrative services
Arts and Humanities
English language
Math and Science
arithmetic, algebra, geometry, calculus, or statistics
Engineering and Technology
computers and electronics
Basic Skills
reading work related information
listening to others, not interrupting, and asking good questions
Problem Solving
noticing a problem and figuring out the best way to solve it
People and Technology Systems
thinking about the pros and cons of different options and picking the best one
figuring out how a system should work and how changes in the future will affect it
Verbal
read and understand what is written
communicate by speaking
Ideas and Logic
make general rules or come up with answers from lots of detailed information
use rules to solve problems
Visual Understanding
see hidden patterns
quickly compare groups of letters, numbers, pictures, or other things
Math
add, subtract, multiply, or divide
People interested in this work like activities that include data, detail, and regular routines.
They do well at jobs that need:
Integrity
Stress Tolerance
Dependability
Attention to Detail
Initiative
Achievement/Effort
You might use software like this on the job:
Spreadsheet software
Microsoft Excel
Presentation software
Microsoft PowerPoint
Document management software
Document management system software
InSystems Calligo Document Management System
bachelor's degree or high school diploma/GED usually needed
Get started on your career:
New job opportunities are less likely in the future.
In the Air Force:
Paralegal; Paralegal Apprentice; Paralegal Craftsman; Paralegal Helper; Paralegal Journeyman; Paralegal Manager; Paralegal Superintendent
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