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