Claims Examiners, Property and Casualty Insurance

Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Report overpayments, underpayments, and other irregularities. Confer with legal counsel on claims requiring litigation.

Median Annual Wage: $62,220

Education: Bachelor's degree (69%); High school diploma or equivalent (12%); Some college, no degree (8%)

Projected Growth: Slower than average (3% to 7%)

Related Job Titles: Claims Examiner; Claims Adjuster; Claims Specialist; Claims Manager; Claims Representative; Customer Care Specialist; Claims Analyst; Claims Supervisor; Home Office Claim Specialist; Corporate Claims Examiner

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Source: O*NET OnLine information for Claims Examiners, Property and Casualty Insurance.

More Business and Financial Operations Careers

  • 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.
  • 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.

Source: O*NET OnLine information for Claims Examiners, Property and Casualty Insurance.

  • Writing - Communicating effectively in writing as appropriate for the needs of the audience.
  • Speaking - Talking to others to convey information effectively.
  • Active Listening - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Negotiation - Bringing others together and trying to reconcile differences.
  • Judgment and Decision Making - Considering the relative costs and benefits of potential actions to choose the most appropriate one.
  • Complex Problem Solving - Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
  • Social Perceptiveness - Being aware of others' reactions and understanding why they react as they do.
  • Monitoring - Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.

Source: O*NET OnLine information for Claims Examiners, Property and Casualty Insurance.

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