Claims Adjusters, Examiners, and Investigators

What Does a Claims Adjusters, Examiners, and Investigators 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.

Day-to-Day Responsibilities

• 1Examine claims forms and other records to determine insurance coverage.
• 2Analyze information gathered by investigation and report findings and recommendations.
• 3Pay and process claims within designated authority level.
• 4Investigate, 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.
• 5Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
• 6Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
• 7Investigate and assess damage to property and create or review property damage estimates.
• 8Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.

Required Skills

• Reading Comprehension
• Active Listening
• Critical Thinking
• Speaking
• Writing
• 4n6xprt Systems StiffCalcs
• ADP software
• Agency Management Systems AMS 360
• Apple Safari
• ARSoftware WinSMAC
• AutoClaims Direct DirectLink
• Automatic Data Processing Autosource
• Automatic Data Processing Claims Manager & Dispatch
• Automatic Data Processing Estimating
• Axonwave Fraud and Abuse Management System

Claims Adjusters, Examiners, and Investigators Salary