How do they match: Claims Adjusters, Examiners, and Investigators

  • Home Office Claims Examiner
  • Home Office Claims Specialist

  • 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.

  • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
  • 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.
  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
  • Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.
  • Refer questionable claims to investigator or claims adjuster for investigation or settlement.
  • 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.