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