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Automation Risk Analysis

Will “Insurance Inspector” 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 Inspector” 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 Inspector” 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

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

  • 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.

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

  • Attend mediations or trials.

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

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

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

  • Collect evidence to support contested claims in court.

  • 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.

  • Obtain credit information from banks and other credit services.

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

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

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

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

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

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

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

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

  • 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.

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

  • Report overpayments, underpayments, and other irregularities.

  • Confer with legal counsel on claims requiring litigation.

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

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

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

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

Technologies & Software

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

Alternative Job Titles