O*NET Career Intelligence

Claims Examiners, Property and Casualty Insurance

SOC 13-1031.01

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.

Zone 4 Business and Financial Operations

Skills

Knowledge

Job Zone

Green

Top Skills 8

Reading Comprehension

3.9

Writing

3.9

Active Listening

3.8

Speaking

3.8

Critical Thinking

3.8

Negotiation

3.6

Judgment and Decision Making

3.5

Monitoring

3.4

Knowledge Areas 8

Customer and Personal Service

4.1

English Language

4.1

Law and Government

3.7

Administration and Management

3.0

Clerical

2.9

Computers and Electronics

2.8

Mathematics

2.8

Building and Construction

2.7

Key Tasks

1Investigate, 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.

2Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

3Resolve complex, severe exposure claims, using high service oriented file handling.

4Pay and process claims within designated authority level.

5Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

Also Known As

Case Manager Casualty Claims Supervisor Check Examiner Claim Auditor Claims Account Manager Claims Account Specialist Claims Adjuster Claims Analyst Claims Auditor Claims Consultant