Investigates, analyzes, and determines the extent of insurance company's liability concerning personal, casualty, or property loss or damages, and attempts to effect settlement with claimants. Corresponds with or interviews medical specialists, agents, witnesses, or claimants to compile information. Calculates benefit payments and approves payment of claims within a certain monetary limit.
This career is part of the Business Management and Administration cluster Business Finance and Accounting pathway.
A person in this career:
- Examines claims forms and other records to determine insurance coverage.
- Investigates and assesses damage to property and creates or reviews property damage estimates.
- Interviews or corresponds with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Reviews police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Negotiates claim settlements and recommends litigation when settlement cannot be negotiated.
- Analyzes information gathered by investigation and report findings and recommendations.
- Interviews or corresponds with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Prepares report of findings of investigation.
- Refers questionable claims to investigator or claims adjuster for investigation or settlement.
- Collects evidence to support contested claims in court.
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