CareerGPS

Claims%20Examiners,%20Property%20and%20Casualty%20Insurance
Summary Occupational Forecast Data for Claims Adjusters, Examiners, and Investigators
Employment Employment Change Average Annual Job Openings Wage & Training Levels
2020 2025 Numerical Percent New Jobs Replacement Jobs Total Median Hourly Median Annual Training Levels
3,278 3,074 -204 -6.23% -41 239 199 $35.74 $74,348 High school diploma or equivalent
Description: 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.
Forecast Data Source: EMSI (4th Quarter 2022)

Occupation Details

The information in this section represents occupational characteristics included in O*NET which defines key features of an occupation as a standardized, measurable set of variables called "descriptors". These distinguishing characteristics of an occupation are described in greater detail in the O*NET Content Model. All items are listed in descending order of importance.

  • 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.
  • Pay and process claims within designated authority level.
  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
  • Resolve complex, severe exposure claims, using high service oriented file handling.
  • Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
  • 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.
  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
  • Present cases and participate in their discussion at claim committee meetings.
  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
  • Confer with legal counsel on claims requiring litigation.

Knowledge

78%
Customer and Personal Service - Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
77%
English Language - Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
69%
Law and Government - Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
51%
Administration and Management - Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.

Skills

72%
Reading Comprehension - Understanding written sentences and paragraphs in work related documents.
72%
Writing - Communicating effectively in writing as appropriate for the needs of the audience.
69%
Active Listening - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
69%
Speaking - Talking to others to convey information effectively.
69%
Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
65%
Negotiation - Bringing others together and trying to reconcile differences.
62%
Judgment and Decision Making - Considering the relative costs and benefits of potential actions to choose the most appropriate one.
60%
Complex Problem Solving - Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
60%
Social Perceptiveness - Being aware of others' reactions and understanding why they react as they do.
60%
Monitoring - Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.
56%
Coordination - Adjusting actions in relation to others' actions.
56%
Service Orientation - Actively looking for ways to help people.
56%
Active Learning - Understanding the implications of new information for both current and future problem-solving and decision-making.
53%
Persuasion - Persuading others to change their minds or behavior.
50%
Time Management - Managing one's own time and the time of others.

Abilities

75%
Oral Comprehension - The ability to listen to and understand information and ideas presented through spoken words and sentences.
75%
Written Comprehension - The ability to read and understand information and ideas presented in writing.
72%
Oral Expression - The ability to communicate information and ideas in speaking so others will understand.
72%
Deductive Reasoning - The ability to apply general rules to specific problems to produce answers that make sense.
69%
Problem Sensitivity - The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
65%
Speech Recognition - The ability to identify and understand the speech of another person.
65%
Speech Clarity - The ability to speak clearly so others can understand you.
65%
Inductive Reasoning - The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).
65%
Written Expression - The ability to communicate information and ideas in writing so others will understand.
62%
Near Vision - The ability to see details at close range (within a few feet of the observer).
62%
Information Ordering - The ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations).
53%
Category Flexibility - The ability to generate or use different sets of rules for combining or grouping things in different ways.
50%
Mathematical Reasoning - The ability to choose the right mathematical methods or formulas to solve a problem.
50%
Selective Attention - The ability to concentrate on a task over a period of time without being distracted.

Work Activities

88%
Getting Information - Observing, receiving, and otherwise obtaining information from all relevant sources.
88%
Resolving Conflicts and Negotiating with Others - Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others.
88%
Interacting With Computers - Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
86%
Communicating with Supervisors, Peers, or Subordinates - Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
84%
Identifying Objects, Actions, and Events - Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events.
84%
Evaluating Information to Determine Compliance with Standards - Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
83%
Making Decisions and Solving Problems - Analyzing information and evaluating results to choose the best solution and solve problems.
82%
Processing Information - Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data.
81%
Documenting/Recording Information - Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.
76%
Organizing, Planning, and Prioritizing Work - Developing specific goals and plans to prioritize, organize, and accomplish your work.
75%
Communicating with Persons Outside Organization - Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail.
74%
Monitor Processes, Materials, or Surroundings - Monitoring and reviewing information from materials, events, or the environment, to detect or assess problems.
72%
Updating and Using Relevant Knowledge - Keeping up-to-date technically and applying new knowledge to your job.
71%
Establishing and Maintaining Interpersonal Relationships - Developing constructive and cooperative working relationships with others, and maintaining them over time.
67%
Analyzing Data or Information - Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts.
64%
Interpreting the Meaning of Information for Others - Translating or explaining what information means and how it can be used.
64%
Performing for or Working Directly with the Public - Performing for people or dealing directly with the public. This includes serving customers in restaurants and stores, and receiving clients or guests.
61%
Thinking Creatively - Developing, designing, or creating new applications, ideas, relationships, systems, or products, including artistic contributions.
61%
Judging the Qualities of Things, Services, or People - Assessing the value, importance, or quality of things or people.
57%
Performing Administrative Activities - Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
54%
Developing Objectives and Strategies - Establishing long-range objectives and specifying the strategies and actions to achieve them.
54%
Inspecting Equipment, Structures, or Material - Inspecting equipment, structures, or materials to identify the cause of errors or other problems or defects.
54%
Estimating the Quantifiable Characteristics of Products, Events, or Information - Estimating sizes, distances, and quantities; or determining time, costs, resources, or materials needed to perform a work activity.
52%
Monitoring and Controlling Resources - Monitoring and controlling resources and overseeing the spending of money.
Title Job Zone Four: Considerable Preparation Needed
Overall Experience A considerable amount of work-related skill, knowledge, or experience is needed for these occupations. For example, an accountant must complete four years of college and work for several years in accounting to be considered qualified.
Job Training Employees in these occupations usually need several years of work-related experience, on-the-job training, and/or vocational training.
Job Zone Examples Many of these occupations involve coordinating, supervising, managing, or training others. Examples include accountants, sales managers, database administrators, teachers, chemists, environmental engineers, criminal investigators, and special agents.
Education Most of these occupations require a four-year bachelor's degree, but some do not.

Interests

Conventional - Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.
Enterprising - Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business.
Investigative - Investigative occupations frequently involve working with ideas, and require an extensive amount of thinking. These occupations can involve searching for facts and figuring out problems mentally.

Work Styles

Integrity - Job requires being honest and ethical.
Dependability - Job requires being reliable, responsible, and dependable, and fulfilling obligations.
Attention to Detail - Job requires being careful about detail and thorough in completing work tasks.
Stress Tolerance - Job requires accepting criticism and dealing calmly and effectively with high stress situations.
Self Control - Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations.
Cooperation - Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.
Persistence - Job requires persistence in the face of obstacles.
Independence - Job requires developing one's own ways of doing things, guiding oneself with little or no supervision, and depending on oneself to get things done.
Analytical Thinking - Job requires analyzing information and using logic to address work-related issues and problems.
Adaptability/Flexibility - Job requires being open to change (positive or negative) and to considerable variety in the workplace.
Initiative - Job requires a willingness to take on responsibilities and challenges.
Concern for Others - Job requires being sensitive to others' needs and feelings and being understanding and helpful on the job.
Achievement/Effort - Job requires establishing and maintaining personally challenging achievement goals and exerting effort toward mastering tasks.

Work Values

Support - Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical.
Independence - Occupations that satisfy this work value allow employees to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy.