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”
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- 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.
- Prepare report of findings of investigation.
- Collect evidence to support contested claims in court.
- 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.
- Obtain credit information from banks and other credit services.
- Analyze information gathered by investigation and report findings and recommendations.
- 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.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
Related Technology & Tools
- Personal digital assistants PDA
- Handheld computers
- Mobile wireless handheld communication devices
- Desktop computers
- Measure markers
- Field computers
- Data collectors
- Total stations
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- CGI-AMS BureauLink Enterprise
- Turtle Creek Software Goldenseal Architect
- LexisNexis RiskWise
- Corporate Systems ClaimsPro
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- CCC Pathways Appraisal Quality Solution
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- ISO ClaimSearch
- CCC EZNet electronic communications network
- Captiva InputAccel
- Castek Insure3 Claims
- CGI INSideOUT
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- Clear Technology Tranzax
- Agency Management Systems AMS 360
- CCC TL2000 Solution
- Injury Sciences EDR InSight
- Covansys ClaimConnect
- Autoclaims Direct DirectLink
- Visual Statement Investigator Suite
- ARSoftware WinSMAC
- CCC GuidePost Decision Support
- Simsol for Adjusters
- Microsoft Word
- MapScenes Evidence Recorder
- 4n6xprt Systems StiffCalcs
- Brightwork Alyce Claims Systems
- InSystems Calligo Document Management System
- QwikQuote software
- CCC Pathways Image Management Solution
- Automatic Data Processing Claims Manager & Dispatch
- Bill review software
- Computerized voice stress analyzer CVSA software
- First Notice Systems ClaimCapture
- Bridium Claims 3
- CSC Colossus
- MapScenes Pro
- Axonwave Fraud and Abuse Management System
- Microsoft Office
- Microsoft Excel
- StrataCare StrataWare eReview
- Document management system software
- ADP software
- Hummingbird Legal Bill Review
- CAD Zone Insurance
- ISO NetMap for Claims
- Magnify Predictive Targeting System
- Automatic Data Processing Autosource
- CSC Automated Work Distributor AWD
- BCCORP Burkitt W5
- Automatic Data Processing Estimating
- Claims processing administration and management software
- IBM Fraud and Abuse Management System