13-1031.00 · Task explorer
Claims Adjusters, Examiners, and Investigators: reported tasks and exploration worksheet
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
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Read the task inventory
This source lists 29 tasks, including 21 marked Core and 6 marked Supplemental. Labels and dates are retained below. Employers can combine or divide these responsibilities differently; explore the task itself before assuming it belongs in every version of the role.
Task source dates: 08/2022, 11/2020.
29 tasks shown
Core · Task 21417 · 08/2022 · Incumbent
Examine claims forms and other records to determine insurance coverage.
Core · Task 21418 · 08/2022 · Incumbent
Analyze information gathered by investigation and report findings and recommendations.
Core · Task 21426 · 08/2022 · Incumbent
Pay and process claims within designated authority level.
Core · Task 21423 · 08/2022 · Incumbent
Investigate, 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.
Core · Task 21428 · 08/2022 · Incumbent
Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
Core · Task 21419 · 08/2022 · Incumbent
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
Core · Task 21420 · 08/2022 · Incumbent
Investigate and assess damage to property and create or review property damage estimates.
Core · Task 21421 · 08/2022 · Incumbent
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
Core · Task 21422 · 08/2022 · Incumbent
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
Core · Task 21429 · 08/2022 · Incumbent
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Core · Task 21425 · 08/2022 · Incumbent
Resolve complex, severe exposure claims, using high service oriented file handling.
Core · Task 21424 · 08/2022 · Incumbent
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Core · Task 21432 · 08/2022 · Incumbent
Confer with legal counsel on claims requiring litigation.
Core · Task 21427 · 08/2022 · Incumbent
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
Core · Task 21434 · 08/2022 · Incumbent
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
Core · Task 21430 · 08/2022 · Incumbent
Refer questionable claims to investigator or claims adjuster for investigation or settlement.
Core · Task 21431 · 08/2022 · Incumbent
Collect evidence to support contested claims in court.
Core · Task 21433 · 08/2022 · Incumbent
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Core · Task 21435 · 08/2022 · Incumbent
Present cases and participate in their discussion at claim committee meetings.
Core · Task 21439 · 08/2022 · Incumbent
Report overpayments, underpayments, and other irregularities.
Core · Task 21443 · 08/2022 · Incumbent
Attend mediations or trials.
Supplemental · Task 21436 · 08/2022 · Incumbent
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Supplemental · Task 21437 · 08/2022 · Incumbent
Conduct detailed bill reviews to implement sound litigation management and expense control.
Supplemental · Task 21440 · 08/2022 · Incumbent
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Supplemental · Task 21441 · 08/2022 · Incumbent
Prepare reports to be submitted to company's data processing department.
Supplemental · Task 21438 · 08/2022 · Incumbent
Examine titles to property to determine validity and act as company agent in transactions with property owners.
Supplemental · Task 21442 · 08/2022 · Incumbent
Obtain credit information from banks and other credit services.
Unspecified · Task 21444 · 11/2020 · Analyst
Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.
Unspecified · Task 21445 · 11/2020 · Analyst
Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.
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Source and practice material
Occupational context uses the O*NET® 31.0 Database from the U.S. Department of Labor, Employment and Training Administration, under CC BY 4.0. View the occupation.
Skill Workbench selected and adapted the occupational information and added its own fictional cases, calculations, guidance and worksheets. USDOL/ETA has not approved, endorsed or tested these additions. O*NET® is a trademark of USDOL/ETA.