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Automation Risk Analysis

Will “Workers' Compensation Claims 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%

“Workers' Compensation Claims 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%

“Workers' Compensation Claims 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

  • Attend mediations or trials.

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

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

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

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

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

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

  • 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.

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

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

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

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

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

  • Obtain credit information from banks and other credit services.

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

  • Report overpayments, underpayments, and other irregularities.

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

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

  • Confer with legal counsel on claims requiring litigation.

  • Collect evidence to support contested claims in court.

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

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

  • 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.

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

  • 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.

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

Technologies & Software

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

Alternative Job Titles