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”
- Examine claims forms and other records to determine insurance coverage.
- Prepare report of findings of investigation.
- Analyze information gathered by investigation and report findings and recommendations.
- 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.
- 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.
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- 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.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
Related Technology & Tools
- Handheld computers
- Mobile wireless handheld communication devices
- Total stations
- Desktop computers
- Personal digital assistants PDA
- Event data recorders
- Measure markers
- Field computers
- Data collectors
- Axonwave Fraud and Abuse Management System
- Hyland OnBase Enterprise Content Management
- Bramerhill ClaimsTech
- Magnify Predictive Targeting System
- Captiva InputAccel
- 4n6xprt Systems StiffCalcs
- Insurance claims fraud detection software
- InSystems Calligo Document Management System
- IBM Fraud and Abuse Management System
- Simsol for Adjusters
- CCC GuidePost Decision Support
- Document management system software
- CAD Zone Insurance
- CSC Colossus
- ARSoftware WinSMAC
- Bridium Claims 3
- Covansys ClaimConnect
- Hummingbird Legal Bill Review
- CSC Automated Work Distributor AWD
- Automatic Data Processing Claims Manager & Dispatch
- Agency Management Systems AMS 360
- MapScenes Evidence Recorder
- Automatic Data Processing Autosource
- First Notice Systems ClaimCapture
- Microsoft Excel
- Claims processing administration and management software
- Turtle Creek Software Goldenseal Architect
- CCC TL2000 Solution
- ISO NetMap for Claims
- Bill review software
- ADP software
- CGI INSideOUT
- StrataCare StrataWare eReview
- Microsoft Word
- Automatic Data Processing Estimating
- Property damage, bodily injury, and liability estimation software
- Brightwork Alyce Claims Systems
- CCC Pathways Image Management Solution
- QwikQuote software
- CCC Pathways Appraisal Quality Solution
- Castek Insure3 Claims
- LexisNexis RiskWise
- Autoclaims Direct DirectLink
- Corporate Systems ClaimsPro
- Microsoft Office
- Computerized voice stress analyzer CVSA software
- ISO ClaimSearch
- CSC Fault Evaluator
- Clear Technology Tranzax
- BCCORP Burkitt W5
- Injury Sciences EDR InSight
- Fair Isaac SmartAdvisor
- Datanex ClaimTrac
- MapScenes Pro
- CCC EZNet electronic communications network
- Visual Statement Investigator Suite
- PhotoModeler
- CGI-AMS BureauLink Enterprise