Low to No Risk

19

Moderate Risk

3

High Risk

3

Extreme Risk

2

• 1Analyze information gathered by investigation and report findings and recommendations.
• 1.2Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
• 2.5Investigate and assess damage to property and create or review property damage estimates.
• 1.4Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
• 1.2Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
• 1.5Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
• 2.3Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
• 1.5Resolve complex, severe exposure claims, using high service oriented file handling.
• 1.5Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
• 2.5Refer questionable claims to investigator or claims adjuster for investigation or settlement.
• 0.3Collect evidence to support contested claims in court.
• 0.2Confer with legal counsel on claims requiring litigation.
• 0.5Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
• 2Present cases and participate in their discussion at claim committee meetings.
• 2Supervise claims adjusters to ensure that adjusters have followed proper methods.
• 2.3Conduct detailed bill reviews to implement sound litigation management and expense control.
• 1.1Examine titles to property to determine validity and act as company agent in transactions with property owners.
• 1.6Communicate with reinsurance brokers to obtain information necessary for processing claims.
• 0.3Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.

17.9% of Claims Adjusters, Examiners, and Investigators tasks can be automated with AI or robotics