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”
- Prepare report of findings of investigation.
- Investigate and assess damage to property and create or review property damage estimates.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Obtain credit information from banks and other credit services.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Examine claims forms and other records to determine insurance coverage.
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
- Collect evidence to support contested claims in court.
- Analyze information gathered by investigation and report findings and recommendations.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
Related Technology & Tools
- Mobile wireless handheld communication devices
- Handheld computers
- Measure markers
- Data collectors
- Personal digital assistants PDA
- Event data recorders
- Desktop computers
- Total stations
- Field computers
- Visual Statement Investigator Suite
- Bramerhill ClaimsTech
- Hyland OnBase Enterprise Content Management
- Injury Sciences EDR InSight
- First Notice Systems ClaimCapture
- CSC Fault Evaluator
- CSC Colossus
- CGI INSideOUT
- 4n6xprt Systems StiffCalcs
- CCC EZNet electronic communications network
- MapScenes Evidence Recorder
- Turtle Creek Software Goldenseal Architect
- InSystems Calligo Document Management System
- BCCORP Burkitt W5
- ISO ClaimSearch
- Automatic Data Processing Claims Manager & Dispatch
- Microsoft Word
- ADP software
- Simsol for Adjusters
- Claims processing administration and management software
- MapScenes Pro
- Document management system software
- Microsoft Office
- Castek Insure3 Claims
- Hummingbird Legal Bill Review
- Automatic Data Processing Estimating
- LexisNexis RiskWise
- Corporate Systems ClaimsPro
- Computerized voice stress analyzer CVSA software
- Covansys ClaimConnect
- Agency Management Systems AMS 360
- CSC Automated Work Distributor AWD
- StrataCare StrataWare eReview
- Autoclaims Direct DirectLink
- QwikQuote software
- Brightwork Alyce Claims Systems
- Property damage, bodily injury, and liability estimation software
- CCC GuidePost Decision Support
- IBM Fraud and Abuse Management System
- PhotoModeler
- Magnify Predictive Targeting System
- CAD Zone Insurance
- Datanex ClaimTrac
- Clear Technology Tranzax
- CCC Pathways Appraisal Quality Solution
- CGI-AMS BureauLink Enterprise
- Fair Isaac SmartAdvisor
- CCC Pathways Image Management Solution
- Axonwave Fraud and Abuse Management System
- ISO NetMap for Claims
- Captiva InputAccel
- Insurance claims fraud detection software
- Automatic Data Processing Autosource
- Bill review software
- Bridium Claims 3
- CCC TL2000 Solution
- ARSoftware WinSMAC
- Microsoft Excel