Career Details

13-1031.00 - Claims Adjusters, Examiners, and Investigators

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.

Key Facts

Bright Outlook

Career Details

Green Job

Career Details

Current Employment

299,700

Estimate

Forecasted Employment

309,500

Estimate

Change in Employment

+9,800

Estimate

Change in Employment %

+3.3%

Estimate

Tasks

The tasks listed below can be performed to prepare you for a career in this field.

Core

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.

Generic

Attend mediations or trials.
Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.
Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.

Supplemental

Supervise claims adjusters to ensure that adjusters have followed proper methods.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Examine titles to property to determine validity and act as company agent in transactions with property owners.
Report overpayments, underpayments, and other irregularities.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Prepare reports to be submitted to company's data processing department.
Obtain credit information from banks and other credit services.

All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.

Knowledge

The items listed below are organized into sections that contain knowledge useful for pursuing a career in this field. Each section also contains a "Percentage of Importance" statistic that shows how relevant an item is to the occupation.

Customer and Personal Service

Administration and Management

Computers and Electronics

Psychology

Education and Training

Economics and Accounting

Communications and Media

Building and Construction

Medicine and Dentistry

All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.

Tools

The tools listed below include machines, equipment, tools, and software that is useful for individuals who are interested in this career.

Computer data input devices

Computers

Master control systems

Length and thickness and distance measuring instruments

Land surveying instruments

All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.

Technology

The technologies listed below include machines, equipment, tools, and software that is useful for individuals who are interested in this career.

Industry specific software

Finance accounting and enterprise resource planning ERP software

Content management software

Business function specific software

Networking software

Data management and query software

Network applications software

Content authoring and editing software

All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.

Certifications

FastForward at Virginia's Community Colleges is a short-term training program for high-demand industries, like healthcare, information technology, and skilled trades and infrastructure, helping Virginians get the jobs and salaries they need. Our goal is to get you trained, help you earn your certification, and get you into a career that can support you and your family. Explore the latest training program offerings by visiting FastForward

The certifications listed below are useful to pursue if you are interested in a career in this field.

Specialty

Advanced

Core

All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.

Licensing

The licensing information below is organized into sections and is useful for pursuing if you are interested in a career in this field.

No specific licensing information is listed for this occupation in the area you have selected.

All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.

Related Programs

Programs related to this career, offered by participating institution(s), are listed below.

Clicking on the Degree programs in the list below will take you away from the Careers page.

INSTITUTION

PROGRAMS

Bridgewater College

Programs

Business Administration Major - BA

Bachelor of Arts

The George S. Aldhizer II Department of Economics and Business Administration offers two majors—economics and business administration—that prepare students to pursue managerial and other professional careers as well as graduate education. We build on the liberal arts foundation provided by the College’s general education program and give each student the knowledge, skills and experience to become a successful and ethical leader, capable of making valued contributions to his or her workplace, society and self. Through a combination of lectures, discussions, case analyses, team projects and presentations, and other in-class activities, courses are designed to integrate economic and business theory and practice; encourage independent and critical thinking using both qualitative and quantitative reasoning; and develop skills in decision making and implementation, teamwork and collaboration, and all forms of communication. Experiential learning opportunities abound through internships, study abroad programs and participation in student organizations, to supplement classroom learning. The economics major consists of 14 courses in economics and mathematics. Economics majors may choose among three tracks: business, government policy and preparation for graduate school via additional mathematics courses. Economics majors can also earn an emphasis in financial economics. The business administration major consists of 15 courses in business, economics and mathematics. To gain greater depth in a particular area of business, many students pursue one of the four concentrations we offer in the business administration major: accounting, finance, marketing and organization management. By taking additional courses, in one of these areas, students build specialization on the solid foundation provided by the business administration major. In addition to the previously mentioned majors, the department also offers minors in business administration, certified financial planning, and economics.

Randolph-Macon College

Programs

Business - Finance (BA)

Bachelor of Arts

A major in business offers students the opportunity to explore theories and concepts from accounting, business, and economics. Students study in an active learning environment and begin to understand and appreciate the complex nature of business organizations through applied economic theory. A major in business prepares students for a career in all business environments and provides an excellent foundation for graduate studies in such fields as business and law. The major in business requires a common core of courses plus one of three concentrations: Finance, Management, or Marketing. All courses in the core and in each concentration must be completed with a grade of C- or better.

Business - Management (BA)

Bachelor of Arts

Business - Marketing (BA)

Bachelor of Arts