Will “Claim Agent” be Replaced By Robots? 🤔
Unknown Chance of Automation
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Job Description
Investigate, analyze, and determine the extent of insurance company's liability concerning personal, casualty, or property loss or damages, and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of claims within a certain monetary limit.
Job Details
- The SOC (Standard Occupational Classification) code is 13-1031.02
☝️ Information based on the reference occupation “Insurance Adjusters, Examiners, and Investigators”.
Also Known As…
- Insurance Adjusters, Examiners, and Investigators
- Litigation Claim Representative
- Independent Insurance Adjuster
- General Adjuster
- Field Liability Generalist
- Claims Specialist
- Claims Representative
- Claims Examiner
- Claims Analyst
- Claims Adjuster
- Claim Representative
- Workers Compensation Claims Adjuster
- Telephone Claims Representative
- Salvage Determiner
- Residential Insurance Inspector
- Property Claims Adjuster
- Property Adjuster
- Multi-line Claims Adjuster
- Medical Claims Specialist
- Medical Claims Examiner
- Medical Claims Analyst
- Material Damage Adjuster
- Job Estimator
- Investigator
- Insurance Inspector
- Insurance Claims Adjuster
- Insurance Appraiser
- Insurance Adjuster
- Inspector
- Health Claims Examiner
- Fire Adjuster
- Field Adjuster
- Examiner
- Estimator
- Disability Specialist
- Disability Examiner
- Compensation Adjuster
- Clerical Adjuster
- Claims Service Adjustor
- Claims Manager
- Claims Assistant
- Claims Adjustor
- Claim Specialist
- Claim Processor
- Claim Investigator
- Claim Inspector
- Claim Examiner
- Claim Approver
- Claim Adjuster
- Catastrophe Claims Supervisor
- Building Appraiser
- Bodily Injury Adjuster
- Benefit Authorizer
- Auto Claims Adjuster
- Arson Investigator
- Appraiser
- Adjustment Clerk
- Adjuster
- Accident Investigator
Tasks for “Claim Agent”
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
- Investigate and assess damage to property and create or review property damage estimates.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Collect evidence to support contested claims in court.
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
- Prepare report of findings of investigation.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- Obtain credit information from banks and other credit services.
Related Technology & Tools
- Personal digital assistants PDA
- Data collectors
- Handheld computers
- Field computers
- Event data recorders
- Mobile wireless handheld communication devices
- Total stations
- Desktop computers
- Measure markers
- ISO ClaimSearch
- Castek Insure3 Claims
- Covansys ClaimConnect
- CCC Pathways Appraisal Quality Solution
- IBM Fraud and Abuse Management System
- Turtle Creek Software Goldenseal Architect
- Hummingbird Legal Bill Review
- Datanex ClaimTrac
- Document management system software
- Microsoft Office
- Clear Technology Tranzax
- CAD Zone Insurance
- Computerized voice stress analyzer CVSA software
- Automatic Data Processing Autosource
- ARSoftware WinSMAC
- CCC TL2000 Solution
- Hyland OnBase Enterprise Content Management
- CGI-AMS BureauLink Enterprise
- Axonwave Fraud and Abuse Management System
- QwikQuote software
- Agency Management Systems AMS 360
- BCCORP Burkitt W5
- ISO NetMap for Claims
- Injury Sciences EDR InSight
- PhotoModeler
- Automatic Data Processing Claims Manager & Dispatch
- Simsol for Adjusters
- Bridium Claims 3
- LexisNexis RiskWise
- Microsoft Word
- ADP software
- Autoclaims Direct DirectLink
- StrataCare StrataWare eReview
- First Notice Systems ClaimCapture
- Brightwork Alyce Claims Systems
- CGI INSideOUT
- CCC Pathways Image Management Solution
- 4n6xprt Systems StiffCalcs
- Property damage, bodily injury, and liability estimation software
- Corporate Systems ClaimsPro
- CSC Colossus
- Automatic Data Processing Estimating
- Claims processing administration and management software
- CCC GuidePost Decision Support
- Bramerhill ClaimsTech
- Captiva InputAccel
- CSC Automated Work Distributor AWD
- Fair Isaac SmartAdvisor
- Bill review software
- InSystems Calligo Document Management System
- Visual Statement Investigator Suite
- MapScenes Pro
- Magnify Predictive Targeting System
- CSC Fault Evaluator
- MapScenes Evidence Recorder
- Microsoft Excel
- Insurance claims fraud detection software
- CCC EZNet electronic communications network