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Insurance Claim Investigator

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AVG. SALARY

$60,910

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EDUCATION

High school (GED) +

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JOB OUTLOOK

Decreasing

What They Do

Claims Adjusters, Examiners, and Investigators Career Video

About This Career

Reviews settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confers with legal counsel on claims requiring litigation. May also settle insurance claims.

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.
  • Analyzes information gathered by investigation and reports findings and recommendations.
  • Reviews police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
  • Investigates and assesses damage to property and creates or reviews property damage estimates.
  • Interviews or corresponds with agents and claimants to correct errors or omissions and to investigate questionable claims.
  • Investigates, evaluates, and settles claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
  • Interviews or corresponds with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
  • Adjusts reserves or provides reserve recommendations to ensure that reserve activities are consistent with corporate policies.
  • Resolves complex, severe exposure claims, using high service oriented file handling.
  • Pays and processes claims within designated authority level.

Working Conditions and Physical Demands

People who do this job report that:

  • You would sit most of the time. There's some walking and standing. You may have to lift and carry things like books, papers or tools weighing 10 lbs. or less.
  • Work in this occupation requires being inside most of the time
  • Work in this occupation involves sitting more than one-third of the time

Working in this career involves (physical activities):

  • Seeing clearly up close
  • Speaking clearly enough to be able to be understood by others
  • Identifying and understanding the speech of another person

Work Hours and Travel

  • Irregular hours
  • Overnight travel

Specialty and Similar Careers

Careers that are more detailed or close to this career:

  • Field Claims Adjuster
  • Claims Adjuster — Investigates insurance claims in order to determine if the policy will cover the damages that are being claimed and to determine if the claim is legitimate.
  • Claims Analyst
  • Claims Examiner
  • Claims Representative
  • Claims Specialist
  • Corporate Claims Examiner
  • Home Office Claims Specialist
  • Litigation Claims Representative
  • General Adjuster