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Automation Risk Analysis

Will “Insurance Adjuster” be Automated?

Historical Context: Oxford Study (2013)

Ranked #675 of 702. Estimated risk: 98.0%

Directly assessed by researchers as likely automatable
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AI Exposure Risk

56%

“Insurance Adjuster” will maybe be replaced by AI.

Based on the cognitive demands, communication requirements, and logical reasoning intrinsic to this occupation according to O*NET data, we project a 56% probability of disruption by generative AI and Large Language Models.

Automation & Robot Risk

33%

“Insurance Adjuster” will probably not be replaced by robots.

Evaluating the physical dexterity, repetitive motion tasks, and manual labor associated with this role, our analysis indicates a 33% likelihood of substitution by advanced robotics systems.

Personal & Financial Insights

Every occupation has a unique profile. For Claims Adjusters, Examiners, and Investigators, the Bureau of Labor Statistics and O*NET classify the day-to-day work broadly as: 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.

Avg. Annual Salary $78,770
Avg. Hourly Wage $37.87
Available Jobs (US) 305,020
Job Title & Hierarchy Code (SOC) Claims Adjusters, Examiners, and Investigators #13-1031
Wage vs. National Median
ℹ️

Data is based on the reference occupation: “Claims Adjusters, Examiners, and Investigators”

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Core Skills & Abilities

  • Examine titles to property to determine validity and act as company agent in transactions with property owners.

  • Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.

  • Prepare reports to be submitted to company's data processing department.

  • Confer with legal counsel on claims requiring litigation.

  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information.

  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

  • Present cases and participate in their discussion at claim committee meetings.

  • Supervise claims adjusters to ensure that adjusters have followed proper methods.

  • Collect evidence to support contested claims in court.

  • Examine claims forms and other records to determine insurance coverage.

  • Resolve complex, severe exposure claims, using high service oriented file handling.

  • Communicate with reinsurance brokers to obtain information necessary for processing claims.

  • Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.

  • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.

  • Pay and process claims within designated authority level.

  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.

  • Investigate and assess damage to property and create or review property damage estimates.

  • Refer questionable claims to investigator or claims adjuster for investigation or settlement.

  • Conduct detailed bill reviews to implement sound litigation management and expense control.

  • Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.

  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

  • Attend mediations or trials.

  • 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.

  • Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.

  • Investigate, 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.

  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

  • Obtain credit information from banks and other credit services.

  • Analyze information gathered by investigation and report findings and recommendations.

  • Report overpayments, underpayments, and other irregularities.

Technologies & Software

  • CCC GuidePost Decision Support
  • Microsoft Office software
  • Microsoft Word
  • Automatic Data Processing Claims Manager & Dispatch
  • ARSoftware WinSMAC
  • Gemini for Workspace
  • Corporate Systems ClaimsPro
  • Simsol for Adjusters
  • Magnify Predictive Targeting System
  • Meta Business AI
  • Planful AI
  • CSC Automated Work Distributor AWD
  • Hummingbird Legal Bill Review
  • Brightwork Alyce Claims Systems
  • MapScenes Evidence Recorder
  • Microsoft Excel
  • AutoClaims Direct DirectLink
  • Insurance claims fraud detection software
  • Automatic Data Processing Autosource
  • ISO ClaimSearch
  • Microsoft Copilot
  • CCC TL2000 Solution
  • CSC Colossus
  • Agency Management Systems AMS 360
  • CGI-AMS BureauLink Enterprise
  • Datanex ClaimTrac
  • Mistral (Mistral AI)
  • Bramerhill ClaimsTech
  • Medical condition coding software
  • IBM Fraud and Abuse Management System
  • Grok (xAI)
  • Axonwave Fraud and Abuse Management System
  • Covansys ClaimConnect
  • Kimi (Moonshot AI)
  • Xactware Xactimate
  • Turtle Creek Software Goldenseal Architect
  • Visual Statement Investigator Suite
  • Microsoft Outlook
  • QwikQuote software
  • Document management system software
  • Computerized voice stress analyzer CVSA software
  • ADP software
  • BCCORP Burkitt W5
  • DeepSeek
  • ChatGPT (OpenAI)
  • StrataCare StrataWare eReview
  • BCCORP W5 for Adjusters
  • Perplexity AI
  • Medical procedure coding software
  • Hyland OnBase Enterprise Content Management
  • Clear Technology Tranzax
  • Bill review software
  • PhotoModeler
  • 4n6xprt Systems StiffCalcs
  • Qwen (Alibaba)
  • Claims processing administration and management software
  • Llama (Meta)
  • Mozilla Firefox
  • Tableau AI
  • Fair Isaac SmartAdvisor
  • Apple Safari
  • CSC Fault Evaluator
  • CGI INSideOUT
  • DataRobot
  • Microsoft Publisher
  • Business software applications
  • MapScenes Pro
  • Injury Sciences EDR InSight
  • Microsoft PowerPoint
  • CCC Pathways Appraisal Quality Solution
  • CCC EZNet electronic communications network
  • Zoom
  • Nova (Amazon)
  • Captiva InputAccel
  • Castek Insure3 Claims
  • InSystems Calligo Document Management System
  • Napkin AI
  • Alteryx AI
  • LexisNexis RiskWise
  • Bridium Claims 3
  • CAD Zone Insurance
  • Gemini (Google)
  • Automatic Data Processing Estimating
  • Property damage, bodily injury, and liability estimation software
  • First Notice Systems ClaimCapture
  • Fair Isaac Claims Advisor
  • CCC Pathways Image Management Solution
  • Healthcare common procedure coding system HCPCS
  • Claude (Anthropic)
  • ISO NetMap for Claims
  • Tropics Claims Reserve Management
  • Microsoft Access
  • Scanners
  • Tablet computers
  • Personal computers
  • Notebook computers
  • Handheld computers
  • Desktop computers
  • Total stations
  • Personal digital assistants PDA
  • Mobile wireless handheld communication devices
  • Measure markers
  • Field computers
  • Event data recorders
  • Data collectors

Alternative Job Titles