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Employment Percentage
-24.40720835
SOC ID
13-1031
SOC Title
Claims Adjusters, Examiners, and Investigators
ONET ID
13-1031.00
ONET Concat ID
13103100
Median Salary
78939.6
Ed Level High School
11.58
Ed Level Certificate
5.91
Ed Level Some College
7.64
Ed Level Associates
5.67
Ed Level Bachelors
69.209999
Ed Level Masters
0
Ed Level Doctors
0
Typical Ed Level
a Bachelor's degree
Career Description
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.
Core 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.
  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
  • Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
  • Refer questionable claims to investigator or claims adjuster for investigation or settlement.
  • Collect evidence to support contested claims in court.
  • Confer with legal counsel on claims requiring litigation.
  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
  • Present cases and participate in their discussion at claim committee meetings.
Start Annual Earnings
47732.92
Top Annual Earnings
120638.7
EMSI Career Title Slug
claims-adjuster-examiner-or-investigator