Occupation Profile for Claims Examiners, Property and Casualty Insurance
Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Report overpayments, underpayments, and other irregularities. Confer with legal counsel on claims requiring litigation.
Signficant Points
- Employment is expected to increase moderately, but many job openings will arise from the need to replace workers who retire or leave for other reasons.
- Licensing and continuing education requirements vary by State.
- College graduates have the best opportunities; competition will be keen for jobs as investigators because this occupation attracts many qualified people.
Knowledge
- Customer and Personal Service — Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
- English Language — Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
- Clerical — Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
- Law and Government — Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
- Computers and Electronics — Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
Skills
- Judgment and Decision Making — Considering the relative costs and benefits of potential actions to choose the most appropriate one.
- Reading Comprehension — Understanding written sentences and paragraphs in work related documents.
- Active Listening — Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
- Writing — Communicating effectively in writing as appropriate for the needs of the audience.
- Critical Thinking — Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Abilities
- Oral Comprehension — The ability to listen to and understand information and ideas presented through spoken words and sentences.
- Oral Expression — The ability to communicate information and ideas in speaking so others will understand.
- Deductive Reasoning — The ability to apply general rules to specific problems to produce answers that make sense.
- Written Comprehension — The ability to read and understand information and ideas presented in writing.
- Problem Sensitivity — The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.