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Date: 02/21/2026

Claims Adjusters, Examiners, and Investigators

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.

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    Work Activities

    Work Activities

    • Analyze information gathered by investigation and report findings and recommendations.
    • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
    • Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
    • Present cases and participate in their discussion at claim committee meetings.
    • Prepare reports to be submitted to company's data processing department.
    • 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.
    • Examine claims forms and other records to determine insurance coverage.
    • Investigate and assess damage to property and create or review property damage estimates.
    • 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.
    • Obtain credit information from banks and other credit services.
    • Resolve complex, severe exposure claims, using high service oriented file handling.
    • Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
    • Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
    • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
    • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
    • Examine titles to property to determine validity and act as company agent in transactions with property owners.
    • Pay and process claims within designated authority level.
    • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
    • Confer with legal counsel on claims requiring litigation.
    • Communicate with reinsurance brokers to obtain information necessary for processing claims.
    • Refer questionable claims to investigator or claims adjuster for investigation or settlement.
    • Collect evidence to support contested claims in court.
    • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
    • Conduct detailed bill reviews to implement sound litigation management and expense control.
    • 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.
    • Attend mediations or trials.
    • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
    • Report overpayments, underpayments, and other irregularities.
    • Resolve complex, severe exposure claims, using high service oriented file handling.
    • Analyze information gathered by investigation and report findings and recommendations.
    • Supervise claims adjusters to ensure that adjusters have followed proper methods.

    Skills

    • Equipment Selection

      Deciding what kind of tools and equipment are needed to do a job.

    • Monitoring

      Keeping track of how well people and/or groups are doing in order to make improvements.

    • Science

      Using scientific rules and strategies to solve problems.

    • Coordination

      Changing what is done based on other people's actions.

    • Writing

      Writing things for co-workers or customers.

    • Management of Personnel Resources

      Selecting and managing the best workers for a job.

    • Systems Analysis

      Figuring out how a system should work and how changes in the future will affect it.

    • Active Learning

      Figuring out how to use new ideas or things.

    • Negotiation

      Bringing people together to solve differences.

    • Reading Comprehension

      Reading work-related information.

    • Persuasion

      Talking people into changing their minds or their behavior.

    • Technology Design

      Making equipment and technology useful for customers.

    • Equipment Maintenance

      Planning and doing the basic maintenance on equipment.

    • Service Orientation

      Looking for ways to help people.

    • Programming

      Writing computer programs.

    • Judgment and Decision Making

      Thinking about the pros and cons of different options and picking the best one.

    • Quality Control Analysis

      Testing how well a product or service works.

    • Social Perceptiveness

      Understanding people's reactions.

    • Complex Problem Solving

      Noticing a problem and figuring out the best way to solve it.

    • Operations Monitoring

      Watching gauges, dials, or display screens to make sure a machine is working.

    • Installation

      Installing equipment, machines, wiring, or computer programs.

    • Operations Analysis

      Figuring out what a product or service needs to be able to do.

    • Operation and Control

      Using equipment or systems.

    • Active Listening

      Listening to others, not interrupting, and asking good questions.

    • Troubleshooting

      Figuring out what is causing equipment, machines, wiring, or computer programs to not work.

    • Management of Financial Resources

      Making spending decisions and keeping track of what is spent.

    • Speaking

      Talking to others.

    • Learning Strategies

      Using the best training or teaching strategies for learning new things.

    • Instructing

      Teaching people how to do something.

    • Repairing

      Repairing machines or systems using the right tools.

    • Management of Material Resources

      Managing equipment and materials.

    • Critical Thinking

      Thinking about the pros and cons of different ways to solve a problem.

    • Time Management

      Managing your time and the time of other people.

    • Systems Evaluation

      Measuring how well a system is working and how to improve it.

    • Mathematics

      Using math to solve problems.

    WorkKeys®

    Applied Math
    5
    Workplace Documents
    5
    Graphic Literacy
    4

    Abilities

    • Speech Recognition

      Recognizing spoken words.

    • Sound Localization

      Noticing the direction that a sound came from.

    • Inductive Reasoning

      Making general rules or coming up with answers from lots of detailed information.

    • Oral Comprehension

      Listening and understanding what people say.

    • Response Orientation

      Quickly deciding if you should move your hand, foot, or other body part.

    • Written Expression

      Communicating by writing.

    • Problem Sensitivity

      Noticing when problems happen.

    • Wrist-Finger Speed

      Making fast, simple, repeated movements of your fingers, hands, and wrists.

    • Near Vision

      Seeing details up close.

    • Deductive Reasoning

      Using rules to solve problems.

    • Flexibility of Closure

      Seeing hidden patterns.

    • Static Strength

      Lifting, pushing, pulling, or carrying.

    • Rate Control

      Changing when and how fast you move based on how something else is moving.

    • Glare Sensitivity

      Seeing something even if there is a glare or very bright light.

    • Multilimb Coordination

      Using your arms and/or legs together while sitting, standing, or lying down.

    • Extent Flexibility

      Bending, stretching, twisting, or reaching with your body, arms, and/or legs.

    • Time Sharing

      Doing two or more things at the same time.

    • Gross Body Equilibrium

      Keeping your balance or staying upright.

    • Far Vision

      Seeing details that are far away.

    • Perceptual Speed

      Quickly comparing groups of letters, numbers, pictures, or other things.

    • Explosive Strength

      Jumping, sprinting, or throwing something.

    • Fluency of Ideas

      Coming up with lots of ideas.

    • Originality

      Creating new and original ideas.

    • Auditory Attention

      Paying attention to one sound while there are other distracting sounds.

    • Spatial Orientation

      Knowing where things are around you.

    • Dynamic Strength

      Exercising for a long time without your muscles getting tired.

    • Peripheral Vision

      Seeing something to your side when your are looking ahead.

    • Number Facility

      Adding, subtracting, multiplying, or dividing.

    • Reaction Time

      Quickly moving your hand, finger, or foot based on a sound, light, picture or other command.

    • Hearing Sensitivity

      Telling the difference between sounds.

    • Written Comprehension

      Reading and understanding what is written.

    • Dynamic Flexibility

      Quickly and repeatedly bending, stretching, twisting, or reaching out with your body, arms, and/or legs.

    • Depth Perception

      Deciding which thing is closer or farther away from you, or deciding how far away it is from you.

    • Finger Dexterity

      Putting together small parts with your fingers.

    • Visual Color Discrimination

      Noticing the difference between colors, including shades and brightness.

    • Gross Body Coordination

      Moving your arms, legs, and mid-section together while your whole body is moving.

    • Speed of Closure

      Quickly knowing what you are looking at.

    • Manual Dexterity

      Holding or moving items with your hands.

    • Speech Clarity

      Speaking clearly.

    • Oral Expression

      Communicating by speaking.

    • Control Precision

      Quickly changing the controls of a machine, car, truck or boat.

    • Stamina

      Exercising for a long time without getting out of breath.

    • Night Vision

      Seeing at night or under low light.

    • Category Flexibility

      Grouping things in different ways.

    • Visualization

      Imagining how something will look after it is moved around or changed.

    • Trunk Strength

      Using your lower back and stomach.

    • Memorization

      Remembering words, numbers, pictures, or steps.

    • Arm-Hand Steadiness

      Keeping your arm or hand steady.

    • Mathematical Reasoning

      Choosing the right type of math to solve a problem.

    • Selective Attention

      Paying attention to something without being distracted.

    • Information Ordering

      Ordering or arranging things.

    • Speed of Limb Movement

      Quickly moving your arms and legs.

    Knowledge

    • Design

      Knowledge of design techniques, tools, and principles involved in production of precision technical plans, blueprints, drawings, and models.

    • Sociology and Anthropology

      Knowledge of group behavior and dynamics, societal trends and influences, human migrations, ethnicity, cultures, and their history and origins.

    • Telecommunications

      Knowledge of transmission, broadcasting, switching, control, and operation of telecommunications systems.

    • Foreign Language

      Knowledge of the structure and content of a foreign (non-English) language including the meaning and spelling of words, rules of composition and grammar, and pronunciation.

    • Law and Government

      Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.

    • History and Archeology

      Knowledge of historical events and their causes, indicators, and effects on civilizations and cultures.

    • 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.

    • English Language

      Knowledge of the structure and content of the English language including the meaning and spelling of words, and rules of composition and grammar.

    • Philosophy and Theology

      Knowledge of different philosophical systems and religions. This includes their basic principles, values, ethics, ways of thinking, customs, practices, and their impact on human culture.

    • 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.

    • Administrative

      Knowledge of administrative and office procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and workplace terminology.

    • Economics and Accounting

      Knowledge of economic and accounting principles and practices, the financial markets, banking, and the analysis and reporting of financial data.

    • Public Safety and Security

      Knowledge of relevant equipment, policies, procedures, and strategies to promote effective local, state, or national security operations for the protection of people, data, property, and institutions.

    • Sales and Marketing

      Knowledge of principles and methods for showing, promoting, and selling products or services. This includes marketing strategy and tactics, product demonstration, sales techniques, and sales control systems.

    • Communications and Media

      Knowledge of media production, communication, and dissemination techniques and methods. This includes alternative ways to inform and entertain via written, oral, and visual media.

    • 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.

    • Mathematics

      Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.

    • Physics

      Knowledge and prediction of physical principles, laws, their interrelationships, and applications to understanding fluid, material, and atmospheric dynamics, and mechanical, electrical, atomic and sub-atomic structures and processes.

    • Medicine and Dentistry

      Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.

    • Therapy and Counseling

      Knowledge of principles, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions, and for career counseling and guidance.

    • 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.

    • Engineering and Technology

      Knowledge of the practical application of engineering science and technology. This includes applying principles, techniques, procedures, and equipment to the design and production of various goods and services.

    • Geography

      Knowledge of principles and methods for describing the features of land, sea, and air masses, including their physical characteristics, locations, interrelationships, and distribution of plant, animal, and human life.

    • Biology

      Knowledge of plant and animal organisms, their tissues, cells, functions, interdependencies, and interactions with each other and the environment.

    • 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.

    • Personnel and Human Resources

      Knowledge of principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.

    • Food Production

      Knowledge of techniques and equipment for planting, growing, and harvesting food products (both plant and animal) for consumption, including storage/handling techniques.

    • Computers and Electronics

      Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.

    • Chemistry

      Knowledge of the chemical composition, structure, and properties of substances and of the chemical processes and transformations that they undergo. This includes uses of chemicals and their interactions, danger signs, production techniques, and disposal methods.

    • Mechanical

      Knowledge of machines and tools, including their designs, uses, repair, and maintenance.

    • Fine Arts

      Knowledge of the theory and techniques required to compose, produce, and perform works of music, dance, visual arts, drama, and sculpture.

    • Transportation

      Knowledge of principles and methods for moving people or goods by air, rail, sea, or road, including the relative costs and benefits.

    • Production and Processing

      Knowledge of raw materials, production processes, quality control, costs, and other techniques for maximizing the effective manufacture and distribution of goods.

    Career Video

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    Pay

    • Ohio Annual Salary 60250/yr
    • Typical Salary
    • Ohio Hourly Wage 28.96/hr
    • Typical Hourly Wage

    Ohio Employment Trends

    • Currently Employed 6,560
    • Yearly Projected Openings 420

    Typical Education

    Personality

    Conventional: People interested in this work like activities that include data, detail, and regular routines.They do well at jobs that need:
    • Cautiousness
    • Integrity
    • Attention to Detail
    • Dependability
    • Perseverance
    • Self-Control

    Tools

    • Automotive computer systems
    • Desktop computers
    • Measuring wheels for distance
    • Notebook computers
    • Personal computers
    • Personal digital assistant PDAs or organizers
    • Portable data input terminals
    • Scanners
    • Tablet computers
    • Theodolites

    Technology

    • Access software
    • Analytical or scientific software
    • Computer aided design CAD software
    • Data base reporting software
    • Data base user interface and query software
    • Desktop publishing software
    • Document management software
    • Electronic mail software
    • Enterprise resource planning ERP software
    • Expert system software
    • Financial analysis software
    • Information retrieval or search software
    • Interactive voice response software
    • Internet browser software
    • Medical software
    • Office suite software
    • Presentation software
    • Spreadsheet software
    • Video conferencing software
    • Word processing software

    Tags

    • InDemand occupations are considered a priority by the state of Ohio.
    • Apprenticeships are available for this occupation. These programs can help you get hands-on experience and build your skills.
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