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Automation Risk Analysis

Will “Property and Casualty Insurance Claims Examiner” 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%

“Property and Casualty Insurance Claims Examiner” 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%

“Property and Casualty Insurance Claims Examiner” 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.

  • 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.

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

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

  • Pay and process claims within designated authority level.

  • 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.

  • 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.

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

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

  • Collect evidence to support contested claims in court.

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

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

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

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

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

  • 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.

  • Attend mediations or trials.

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

  • Obtain credit information from banks and other credit services.

  • Confer with legal counsel on claims requiring litigation.

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

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

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

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

  • Report overpayments, underpayments, and other irregularities.

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

Technologies & Software

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

Alternative Job Titles