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Insurance (Claim) Adjusters investigate, evaluate, and settle claims on insurance policies resulting from accidents, fires, injuries, embezzlement of funds, and property loss and damage. Whenever possible, they attempt to make out-of-court settlements with the claimant.
JOB DUTIES
Claim Adjusters may:
Determine whether or not the claim is covered by the insurance policy
Determine the amount of damage done
Prepare a detailed report of findings
Try to work out a fair settlement
Recommend any legal action necessary
Prepare a file for use in court action
Interview or correspond with the person making the claims and talk with witnesses
Inspect and estimate property damage or loss
Consult police, fire departments, and medical reports and records
Take pictures and draw diagrams to support written information in the report
Attend court hearings when a settlement cannot be agreed upon
Claim representatives are making greater use of computers to keep records of clients and actions taken in various claims. Most have computer terminals on their desks, and many use portable laptop computers to enter or access information when they are on assignment outside the office.
OCCUPATIONAL SPECIALTIES
Insurance Adjusters may specialize in these areas:
241.217-010 CLAIM ADJUSTERS investigate insurance clients' claims for loss or damages. Whenever possible, they attempt to make out-of-court settlements with the claimant.
241.267-018 CLAIM EXAMINERS, known as pre-claim examiners, analyze insurance claims to determine the amount of the insurance company's liability and settle claims with policyholders according to policy provisions. Some Claim Examiners, known as post-claim examiners, work in the home offices of insurance companies and review settled claims to determine whether or not payments have been made according to company practices and policies.
241.267-030 INVESTIGATORS assist Adjusters in gathering information needed to reach a fair settlement with individuals or businesses on insurance claims.
In addition to learning about these specialties, you may also find it helpful to explore the following Career Exploration Scripts:
WORKING CONDITIONS AND REQUIREMENTS
Claim Adjusters, Investigators, and Examiners work under general supervision. They might supervise office and field staff.
Claim Adjusters spend their time investigating claims where fires, accidents, disasters, or injuries occur. They also spend time in offices writing reports. Some travel may be required in order to obtain information and inspect property. Many companies centralize the claims operation in a drive-in claims center, where the cost of repair is determined and a check is issued immediately.
Claim Adjusters usually plan their own schedules for investigating claims since they must travel to the scene of the loss or to the client's home. They often work in the evening and on weekends. In the case of emergencies, they may be on 24-hour call. The normal workweek for Claim Examiners and Investigators is 5-day, 40-hours.
Some Adjusters may work up to 60 hours a week (with overtime).
A company car is usually supplied, but some Adjusters and Examiners may have to use their own cars and be reimbursed for travel costs.
Claim Adjusters, Investigators, and Examiners may choose to join professional associations such as The National Association of Public Adjusters and may be required to pay dues.
You Should Prefer:
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Activities concerned with the communication of data
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Activities of a technical nature
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Activities involving business contact with people
You Should Be Able To:
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Communicate well, both orally and in writing
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See details and recognize errors in written materials
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Use arithmetic quickly and accurately
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Influence people in their judgments about ideas and things
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Make decisions using personal judgment and standards
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Deal effectively with people in actual job duties
Math Problem You Should Be Able to Solve:
Your client was in an accident and the damages are $550.00. Your client has a $250.00 deductible. How much will the insurance company pay?
Reading Example You Should Be Able to Read and Comprehend:
You should be able to read and understand terminology used in an insurance policy. For example, "This coverage provides no-fault insurance benefits for a covered person's injuries resulting from an accident, regardless of fault.
Writing Example You Should Be Able to Produce:
Prepare a policy termination notice for a client who is canceling his insurance.
Thinking Skill You Should Be Able to Demonstrate:
When dealing with insurance there are many rules and regulations to follow. As an insurance adjuster, you need to know all of the rules and regulations and when they apply to be able to inform and consult clients.
Some large insurance companies provide on-the-job training and home-study courses for entry-level claim adjusters and examiners. For example, material damage adjusters would learn about automobile body construction, analysis of collision data, and repair cost estimation, including computerized estimating equipment. They also learn how to deal with customers.
Workers may receive their training through courses offered by the Insurance Institute of America, a nonprofit organization offering educational programs and professional certification to persons in the property-liability insurance industry. The Insurance Institute of America offers an Associate in Claims designation upon successful completion of 4 essay examinations. Adjusters can prepare for the examination by independent home study or through company or public classes. The Institute also offers a certificate upon successful completion of the Introduction to Claims program and examination.
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EDUCATION AND PREPARATION OPPORTUNITIES
NOTE: On-The-Job Training provided by the employer or an Associate Degree (two years of study beyond high school) or a Bachelor's Degree (four years of study beyond high school) may qualify a person for this occupation.
The following education and preparation opportunities are helpful in preparing for occupations in this Career Exploration Script:
***SCHOOL SUBJECTS***
0300 AUTOMOTIVE , 0600 BUSINESS , 0700 CAREERS , 0900 COMMUNICATIONS , 1000 COMPUTERS , 1100 ECONOMICS , 1300 ENGLISH , 2200 MATH , 2800 PUBLIC SPEAKING , 2900 SCIENCE , 3000 SOCIAL STUDIES
***VOCATIONAL EDUCATION PROGRAMS***
There are no Vocational Education Programs related to this Career Exploration Script.
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Students should obtain the local
Career Education Consumer Report
for information on what happens to students who successfully complete a program. This information is available at each high school or career/technical center.
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***POSTSECONDARY PROGRAMS***
084 INSURANCE
Programs in Insurance provide opportunities to gain the knowledge and skills for careers in the insurance industry.
Courses vary from school to school but may include:
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Principles of Insurance
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Risk Management
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Homeowners & Auto Insurance
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Statistical Inference
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Life Insurance
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Salesmanship
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Property & Casualty Insurance
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Strategy Formulation
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Health Insurance
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Consumer Behavior
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Marine Insurance
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Pensions & Social Insurance
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Bonding
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Search for a College and/or Instructional Program
***APPRENTICESHIP OPPORTUNITIES***
There are no Apprenticeships related to this Career Exploration Script.
***MILITARY TRAINING OPPORTUNITIES***
There are no Military Programs related to this Career Exploration Script.
E-Learning Courses and Programs
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OPPORTUNITIES FOR EXPERIENCE AND METHODS OF ENTRY
In
Michigan
, Insurance Adjusters must be licensed by the Office of Financial and Insurance Services of the Michigan Department of Labor & Economic Growth (MDLEG). Click
here
for "Michigan Licensed Occupations," see Insurance Adjuster for specific licensing information..
School-to-Work opportunities include:
informal apprenticeships
mentorships
job shadowing experiences
touring a local Insurance Adjuster employer
internships
volunteer work with a Insurance Adjuster employer
community service work with an agency
Experience may be gained through part-time or summer work handling clerical duties in an insurance company. Many professional associations sponsor courses in all phases of insurance work. Postsecondary programs in insurance may offer co-op or work experience opportunities.
Methods of becoming an Insurance Adjuster include direct application to employers and referrals through employees. Assistance is available from college placement offices, local offices of Michigan Works!, and newspaper want ads. In addition, you should access and search the Internet's on-line employment services sites such as:
You should also enter an electronic resume on these on-line services.
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EARNINGS AND ADVANCEMENT
Earnings of Claim Adjusters and Examiners depend on the individual's experience and the level of the job. Those in senior and supervisory positions have the highest earnings.
Nationally, recent college graduates with a bachelor's degree in the insurance claims field were offered an average salary of $35,204 per year by insurance firms in late 2006. Their offers ranged between $30,000 and $40,000. Claim Adjusters with considerable experience earned between $43,100 and $57,200 per year. Most claims managers earned between $67,200 and $89,200 a year, including bonuses. The median yearly earnings of "all" workers in the
U.S.
were $33,852 in 2005.
The State of
Michigan
employs medical benefits reviewers to examine insurance claims. In mid 2006, their salary range was $26,678 to $39,609yearly.
Some insurance companies have bonus/incentive plans in which workers may receive additional compensation based on the company's performance during the year or on some other criteria.
Depending on the employer, fringe benefits usually include life, accident, disability, and hospitalization insurance; paid vacations and holidays; sick leave; and pension plans. Adjusters usually receive a company car or reimbursement for business use of their own cars.
Claim Examiners and Adjusters are usually hired into trainee positions. They may advance to senior and supervisory positions. Some may start their own businesses and become public Adjusters or independent Adjusters representing insurance companies. Qualified Claim Examiners can also advance to positions in technical claims at a home office, in underwriting, or administration. Job experience and insurance education are needed to advance beyond the trainee levels for both Adjusters and Examiners.
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EMPLOYMENT AND OUTLOOK
Nationally, about 250,300 Insurance Adjusters and Examiners were employed in2004. Employment of Insurance Adjusters and Examiners is expected to grow about as fast as the average for all occupations through the year 2014. Growth is expected because of expanding insurance sales and claims. There should be limited opportunities for Adjusters specializing in auto claims in states with no-fault insurance plans and favorable prospects for other types of Adjusters. Employment opportunities are expected to be good for women qualified as Adjusters.
Additional openings will result as workers change jobs, retire, or leave the occupation for other reasons. About 2.1% of them were self-employed. The industry distribution for Insurance Adjusters and Examiners looked like this:
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NAICS Code
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NAICS Industry Title
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% Employed
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524100
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Insurance carriers
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59.6
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550000
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Management of companies and enterprises
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3.5
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920000
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State government
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3.1
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560000
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Administrative and support and waste management and remediation services
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2.4
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525000
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Funds, trusts, and other financial vehicles
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1.8
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--
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Others
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29.6
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There are about 4,350 Insurance Adjusters and Examiners employed in Michigan. Most worked in the insurance industry.
Employment in this occupation is expected to grow faster than the average for all occupations through the year 2012. An average of 120 openings is expected annually, with 70 due to growth and 50 due to replacement of workers who retir