Claims Examiners, Property and Casualty Insurance Go Back to List 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.

Tasks
	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.
	Pay and process claims within designated authority level.
	Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
	Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
	Resolve complex, severe exposure claims, using high service oriented file handling.
	Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
	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.
	Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
	Present cases and participate in their discussion at claim committee meetings.
	Contact or interview claimants, doctors, medical specialists, or employers to get additional information.

Skills
	Writing - Communicating effectively in writing as appropriate for the needs of the audience.
	Reading Comprehension - Understanding written sentences and paragraphs in work related documents.
	Active Listening - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
	Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
	Speaking - Talking to others to convey information effectively.
	Negotiation - Bringing others together and trying to reconcile differences.
	Judgment and Decision Making - Considering the relative costs and benefits of potential actions to choose the most appropriate one.
	Complex Problem Solving - Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
	Monitoring - Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.
	Social Perceptiveness - Being aware of others' reactions and understanding why they react as they do.

Knowledge
	Customer and Personal Service - Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
	English Language - Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
	Law and Government - Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
	Administration and Management - Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
	Clerical - Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
	Computers and Electronics - Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
	Mathematics - Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
	Building and Construction - Knowledge of materials, methods, and the tools involved in the construction or repair of houses, buildings, or other structures such as highways and roads.
	Psychology - Knowledge of human behavior and performance; individual differences in ability, personality, and interests; learning and motivation; psychological research methods; and the assessment and treatment of behavioral and affective disorders.
	Education and Training - Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects.

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Education & Training   Education:   Most of these occupations require a four-year bachelor's degree, but some do not.   Related Experience:   A considerable amount of work-related skill, knowledge, or experience is needed for these occupations. For example, an accountant must complete four years of college and work for several years in accounting to be considered qualified.

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Wage Information
	Region Average Entry Level  Mid-Range  Annual  Hourly  Statewide $91,909.00 $44.19  $29.55  $32.06 - $51.10  Bridgeport/Stamford $98,467.00 $47.34  $30.61  $32.36 - $53.51  Danbury $94,979.00 $45.66  $27.04  $29.63 - $53.32  Hartford $93,694.00 $45.05  $30.55  $32.42 - $51.10  New Haven $88,727.00 $42.66  $30.23  $33.16 - $48.57  New London/Norwich $85,525.00 $41.12  $24.97  $30.23 - $50.37  Waterbury $80,263.00 $38.59  $27.12  $28.91 - $46.54  Torrington $83,873.00 $40.33  $24.47  $29.09 - $54.27

Occupation Outlook ( 2016 - 2026 ) Average Annual Job Openings:   225   Employment in this occupation is expected to grow more slowly than average, but the number of annual openings will offer very good job opportunities.

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	Some of the occupational information on this page is formulated from O*NETTM v17.0 data. O*NETTM is a trademark of the U.S. Department of Labor, Employment and Training Administration.