Insurance Adjusters and Claims Examiners

Nature of work

Insurance adjusters investigate insurance claims on behalf of insurance companies and government insurers and determine the validity and the amount of loss or damages covered by insurance policies. They work for claims departments of insurance companies or as independent adjusters. Insurance claims examiners examine claims investigated by insurance adjusters and authorize payments. They work at head offices or branches of insurance companies.

Job duties

Insurance adjusters:

• Investigate circumstances surrounding insurance claims to determine validity of claim.
• Inspect vehicle, home or other property damage.
• Take statements and consult with claimants, accident witnesses, doctors and other relevant individuals and examine records or reports.
• Determine amount of loss or damages covered by insurance policies.
• Negotiate settlement of claims.
• Prepare adjustment reports.

Insurance claims examiners:

• Review, examine, calculate and authorize insurance claims investigated by insurance adjusters.
• Examine adjusters' reports and similar insurance claims or precedents to determine extent of insurance coverage.
• Make sure claims are valid and settlements are made according to company practices and procedures.
• Consult lawyers, doctors or other relevant individuals to discuss insurance claims.
• Approve vehicle, fire, life, disability, dental or other insurance claims.

Sample job titles

• claims consultant
• disability claims examiner
• insurance adjuster
• insurance inspector
• liability adjuster
• medical claims assessor
• motor vehicle claims adjuster
• property adjuster - insurance
• settlement specialist

Skills

• You must be organized, analytical, and decisive. You need good spoken and written communication skills. You need good interpersonal skills, especially when dealing with clients who are upset or experiencing stress. You must be able to work as part of a team. Knowledge of medical terminology and computer skills are helpful.

Job requirements

• High school is required.
• A bachelor's degree, college diploma or some post-secondary education or several years of experience as a clerk in the claims department or other general insurance experience.
• Several years of on-the-job training and completion of insurance industry courses and training programs.
• Independent adjusters need a provincial licence issued by the Superintendent of Insurance in the province of employment.

Other considerations

• Completion of educational programs through the Insurance Institute of Canada or its provincial counterparts entitles insurance adjusters and claims examiners to professional recognition as a Chartered Insurance Professional (CIP), and with additional university courses, as a Fellow Chartered Insurance Professional (FCIP).

Regulations

Contacts

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