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Automation Risk Analysis

Will “Reinsurance Claims Analyst” 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%

“Reinsurance Claims Analyst” 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%

“Reinsurance Claims Analyst” 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 reinsurance brokers to obtain information necessary for processing claims.

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

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

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

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

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

  • Attend mediations or trials.

  • Collect evidence to support contested claims in court.

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

  • 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.

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

  • Confer with legal counsel on claims requiring litigation.

  • 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.

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

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

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

  • Obtain credit information from banks and other credit services.

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

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

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

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

  • Report overpayments, underpayments, and other irregularities.

  • 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.

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

  • 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.

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

Technologies & Software

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

Alternative Job Titles