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Occupation information for

Claims Examiners, Property and Casualty Insurance
District Of Columbia

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description

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.

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details

Currently Employed: 950

Projected Annual Job Openings: 20

Typical Hourly Wage: $27.33 - $44.23

Typical Annual Salary: $56,800 - $92,000

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typical training

Typical education needed for entry: High school diploma or equivalent

Typical work experience needed for a job in this occupation: None

Typical on-the-job training once you have a job in this occupation: Long-term on-the-job training

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typical job duties

  • Supervise claims adjusters to ensure that adjusters have followed proper methods.
  • 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.
  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
  • Resolve complex, severe exposure claims, using high service oriented file handling.
  • Pay and process claims within designated authority level.
  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
  • 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.
  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
  • Confer with legal counsel on claims requiring litigation.
  • Conduct detailed bill reviews to implement sound litigation management and expense control.

tools & technology


Tools:
  • Desktop computers
  • Notebook computers
  • Personal computers
  • Personal digital assistant PDAs or organizers
  • Tablet computers

Technology:
  • Access software
  • Analytical or scientific software
  • Data base user interface and query software
  • Document management software
  • Expert system software

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