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How to Become a Claims Adjuster

If you are interested in opportunities for career advancement in the insurance field, a claims adjuster might be the perfect role for you. Claims adjusters investigate, assess, and resolve all types of insurance claims. To be successful as a claims adjuster, you will need to be detail-oriented, have excellent interpersonal skills, and have outstanding investigative skills. Your job as a claims adjuster will involve examining damages to people and property, interviewing witnesses, policemen and subject experts, and determining the monetary value owed to the claimant.

Claims adjusters might work directly with customers, insurance companies, or agents to collect and analyze information to ensure that all claims are handled fairly. You’ll also have to have a good understanding of company policy and work within those rules in handling claims.

Sample job description

We seeking a highly motivated claims adjuster to join our team. Claims adjusters establish the business parameters of each claim by analyzing customer applications, company guidelines, laws/regulations, and cost-effectiveness. They also interpret computerized data systems to determine the scope of coverage available for losses that may occur within a policy or aggregate policy, identify covered properties, and assess risk. The responsibilities of claims adjusters include evaluating, investigating, and resolving claims according to company policy and state laws, establishing business parameters of every claim, communicating with customers throughout the claims process, and monitoring claims for possible fraud and misrepresentation. As a claims adjuster, you’ll be responsible for helping customers get back on the road after an accident. You’ll have the support of a collaborative team and ongoing coaching from leaders.

Typical duties and responsibilities

  • Investigate insurance claims and determine if the insurance company should pay the claim
  • Review medical records, police reports, and other documents related to the claim
  • Determine the value of a claim and whether the insurance company should pay for damages, medical expenses, or other losses
  • Prepare reports on their findings and make recommendations to the insurance company
  • Negotiate with claimants to reach a settlement
  • Represent the insurance company in court proceedings if a claim goes to trial

Education and experience

  • A college degree is not required for this job, but some insurance companies may prefer to hire claims adjusters with a degree in business, economics, mathematics, or a related field
  • Claims adjusters typically have at least three years of experience investigating insurance claims
  • The ability to investigate each claim thoroughly and accurately
  • They must be able to communicate effectively with claimants, witnesses, lawyers, insurance company representatives, doctors, and other professionals

Required skills and qualifications

  • Thorough knowledge of insurance claims process
  • Investigative skills
  • Strong communication and negotiation skills
  • Problem-solving skills
  • Ability to work independently
  • Ability to travel around the state

Preferred qualifications

  • Bilingual abilities
  • Familiarity with computers and software applications used in investigations, including databases and specific claims software programs
  • Strong negotiation skills are important for this job
  • They should have good problem-solving skills since claims can become very complicated
  • Experience in the insurance industry is helpful, but not always necessary, as many claims adjusters come from a customer service background

Typical work environment

Claims adjusters typically work in an office setting. They may have to travel, sometimes overnight, to meet with claimants or insurance company representatives. They may also negotiate with claimants by phone. The job of a claims adjuster can be very challenging, but it can also be very rewarding. They play an important role in the insurance industry, and their work can have a direct impact on the claimants they work with. Claims adjusters must have good investigative skills, strong communication skills, and the ability to negotiate settlements.

Typical hours

This is a full-time job, and the hours can be long. Claims adjusters may have to work overtime to meet deadlines or resolve complex claims. They may also have to travel to meet with claimants or insurance company representatives.

Available certifications

There are a few certifications available for claims adjusters. However, this is the most popular one:

  • AdjusterPro Claims Adjuster License. This online pre-licensing course includes an online state exam and satisfies all state requirements. No additional coursework or testing is needed. Offered 100% online, our program allows you to complete your training anywhere, anytime.

Career path

A claims adjuster’s career path can vary depending on your level of experience, education, and certifications. Many insurance companies prefer to hire candidates with an undergraduate degree in finance, business, or insurance, so you will most likely need to go to college and earn a degree in one of these related fields.

US, Bureau of Labor Statistics’ job outlook

SOC Code: 13-1030

2020 Employment349,400
Projected Employment in 2030340,500
Projected 2020-2030 Percentage Shift 3% decrease
Projected 2020-2030 Numeric Shift8,900 decrease

Claims adjusters evaluate the extent of an insurance company’s liability for personal and property damage, illness, or other loss. As a result, claims adjusters work to protect the profitability of their organization by minimizing payouts on claims while ensuring that legitimate claims are paid promptly and in full. In general, claims adjusters work under the supervision of a supervisor, who may be a manager, supervisor, or claims examiner.

As more insurance policies are written and businesses contract to cover their property and liability risks, the number of claims will inevitably rise. The need for qualified claims adjusters will also increase as companies hire staff or outsource this function to third parties.

The US Bureau of Labor Statistics projects that the employment of claims adjusters, examiners, and investigators will decrease by 3% from 2020 to 2030. This projected decline is slower than the average for all occupations.