Claims Adjusters, Appraisers, Examiners, and Investigators

You should be strong critical thinker with great interpersonal skills and communication skills; a little interest in detective work will be icing on the cake to become Claims Adjusters, Appraisers, Examiners, and Investigators.

Claims Adjusters, Appraisers, Examiners, and Investigators mainly act as intermediaries between insurance companies and public. They inspect property damage to determine how much the insurance company should pay for the loss. The property they inspect could be a home, a business, or an automobile.
  • Appraisers estimate the cost or value of an insured item.
  • Claims examiners review claims after they are submitted to ensure that proper guidelines have been followed by claimants and adjusters.
  • Insurance investigators handle claims in which the company suspects fraudulent or criminal activity such as arson, staged accidents, or unnecessary medical treatments.

Role of Claims Adjusters, Appraisers, Examiners, and Investigators

  • Investigate, evaluate, and settle insurance claims.
  • Determine whether the insurance policy covers the loss claimed.
  • Decide the appropriate amount the insurance company should pay.
  • Ensure that claims are not fraudulent.
  • Contact claimants’ doctors or employers to get additional information on questionable claims
  • Confer with legal counsel on claims when needed.
  • Keep claims files, such as records of settled claims and an inventory of claims requiring detailed analysis.
  • Negotiate settlements.
  • Authorize payments.

Skills of Claims Adjusters, Appraisers, Examiners, and Investigators

Analytical skills:  Adjusters and examiners must have analytical skills so insurance company pays a fair claim and carefully consider various pieces of information to reach a decision.

Communication skills: Claims adjusters and investigators get information from a wide range of people, including claimants, witnesses, and medical experts so they need sound communication skills.

Interpersonal skills: Adjustors, examiners, and investigators workers must be understanding and yet firm with their company’s policies.

Math skills: Appraisers must be able to calculate property damage.

Work Schedules

  • Most claims adjusters, appraisers, examiners, and investigators work full time. However, their work schedule vary.
  • Adjusters often work during weekend and arrange their work schedules to accommodate evening appointments with clients.  They have irregular schedules.
  • Auto damage appraisers typically work regular hours and rarely work on the weekends, although they often spend much of their time at automotive body shops estimating vehicle damage costs.
  • Insurance investigators often work irregular schedules because of the need to conduct surveillance and contact people who are not available during normal working hours. Early morning, evening, and weekend work is common.

Some Job Titles

Claims Representative, Claims Adjuster, Claims Examiner, Claims Analyst, Claims Specialist, Claim Representative, General Adjuster, Independent Insurance Adjuster, Litigation Claim Representative, Field Liability Generalist

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