Insurance Adjusters and Examiners

Career summary

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Insurance adjusters investigate property and casualty insurance claims. Claims examiners work in life and health insurance and perform the same duties.

Adjusters and examiners may inspect claims from a variety of events, including:

• Burglaries
• Car accidents
• House fires

When policyholders file claims, adjusters first determine whether customers' insurance policies cover the loss. They estimate the amount of the loss. Adjusters often visit the property to assess the damage for themselves. They interview the people making the claims and gather information about the property that was stolen or damaged. They also gather information if people were hurt. If there are police or hospital records, adjusters copy and read them.

Adjusters may contact insurance agents or claimants to get additional information or verify it. Adjusters write reports outlining the facts of claims and explaining their decisions.

Sometimes claimants are not happy with the amount of money they receive. When this occurs, adjusters negotiate with claimants to find payments that are acceptable to insurance companies and claimants. These negotiations are not always successful and cases sometimes go to court. Adjusters and examiners talk to lawyers before the hearings. They may testify in court.

Adjusters and examiners are also called claim investigators or claim representatives. Some adjusters work specifically in the field of workers' compensation. They manage payments for time loss and medical expenses.

Related careers

This career is part of the Finance cluster of careers.

Related careers include:

• Appraisers and Assessors
• Brokerage Clerks
• Buyers and Purchasing Agents
• Compliance Officers and Inspectors
• Cost Estimators
• Credit Analysts
• Credit Checkers and Authorizers
• Government Benefits Interviewers
• Insurance Policy and Claims Clerks
• Insurance Underwriters
• Loan Clerks
• Regulatory Affairs Specialists
• Tax Examiners
• Title Examiners and Searchers

Job duties

Task list

The following list of tasks is specific to insurance adjusters and examiners.

• Inspect damaged properties and estimate amount of loss.
• Determine if claimants' policies cover the type of damage they are claiming.
• Analyze information about claims. May contact policyholders or insurance agents to clarify information.
• Negotiate with policyholders to settle claims.
• Help insurance companies determine how much money they need in reserve to cover future losses.
• Talk to policyholders, witnesses, and police to gather information. Read hospital records and police reports.
• Pay and process claims. Verify and analyze data to make sure claims are valid and that company policies are followed.
• Write reports explaining their decisions.
• Gather evidence to support contested claims in court. Meet with lawyers.
• May work with attorneys and testify in court.
• Enter information into computers and keep records of all claims.

Common work activities

Insurance adjusters and examiners perform the following tasks. These tasks are common to many careers.

• Use computers
• Get information needed to do the job
• Make decisions and solve problems
• Communicate with supervisors, peers, or subordinates
• Resolve conflicts and negotiate with others
• Identify objects, actions, and events
• Document and record information
• Process information
• Evaluate information against standards
• Communicate with people outside the organization
• Organize, plan, and prioritize work
• Analyze data or information
• Update and use job-related knowledge
• Establish and maintain relationships
• Monitor events, materials, and surroundings
• Explain the meaning of information to others
• Perform for or work with the public
• Judge the value of objects, services, or people
• Think creatively
• Perform administrative tasks
• Estimate sizes, quantities, time, cost, or materials needed

Work requirements

Working conditions

In a typical work setting, insurance adjusters and examiners:

Interpersonal relationships

• Have a high level of social contact. They work closely with claimants, agents, and lawyers.
• Often deal with claimants who are angry, upset, or rude.
• Are often placed in conflict situations when people do not like their decisions.
• Are responsible for work outcomes and results of other workers.
• Communicate with claimants, agents, and lawyers daily by telephone, e-mail, or in person.
• Write letters and memos on a daily basis.
• Work in a group or as part of a team.

Physical work conditions

• Usually work indoors, but occasionally work outdoors when evaluating property loss.
• Are often exposed to sounds and noise levels that are distracting and uncomfortable, such as from a busy office.
• Work somewhat close to other people, such as when sharing office space.

Work performance

• Must be exact in their work. Errors could prevent claimants from receiving the payments they deserve.
• Must repeat the same mental activities, such as analyzing information about claims.
• Make decisions on a daily basis that strongly impact the company and claimants. They rarely consult a supervisor before making a decision.
• Are able to set most tasks and goals without talking to a supervisor.
• Are moderately competitive with other insurance adjusters and examiners.
• Must meet strict deadlines on a daily basis.

Hours/travel

• Generally have a set schedule each week.
• Usually work more than 40 hours a week.
• May work overtime after floods or big storms, when many people experience property loss.
• May work nights and weekends to take statements from witnesses or claimants.

Physical demands

Insurance adjusters and examiners frequently:

• Sit for long periods of time.
• Repeat the same movements.

It is important for insurance adjusters and examiners to be able to:

• Speak clearly so listeners can understand.
• See details of objects that are less than a few feet away.
• Understand the speech of another person.

It is not as important, but still necessary, for insurance adjusters and examiners to be able to:

• See details of objects that are more than a few feet away.
• Use fingers to grasp, move, or assemble very small objects.
• See differences between colors, shades, and brightness.
• Focus on one source of sound and ignore others.

Skills and abilities

Insurance adjusters and examiners need to:

Communicate

• Understand spoken information.
• Understand written information.
• Speak clearly so listeners can understand.
• Read and understand work-related materials.
• Listen to others and ask questions.
• Write clearly so other people can understand.

Reason and problem solve

• Use reasoning to discover answers to problems.
• Analyze ideas and use logic to determine their strengths and weaknesses.
• Combine several pieces of information and draw conclusions.
• Notice when something is wrong or is likely to go wrong.
• Follow guidelines to arrange objects or actions in a certain order.
• Understand new information or materials by studying and working with them.
• Judge the costs and benefits of a possible action.
• Recognize the nature of a problem.
• Develop rules that group items in various ways.

Use math and science

• Choose a mathematical method or formula to solve problems.
• Add, subtract, multiply, and divide quickly and correctly.

Manage oneself, people, time, and things

• Check how well one is learning or doing something.
• Manage the time of self and others.

Work with people

• Solve problems by bringing others together to discuss differences.
• Be aware of others' reactions and understand the possible causes.
• Look for ways to help people.
• Change behavior in relation to others' actions.
• Persuade others to approach things differently.

Education and training

Educational programs

The programs of study listed below will help you prepare for the occupation or career cluster you are exploring.

Programs of study directly related to this occupation

• Insurance

Other programs of study to consider

• Anatomy
• Architecture
• Auto Body Repair
• Civil Engineering
• Finance
• Fire Protection Technology
• Law Enforcement and Police Science
• Physiology
• Real Estate

Training

To work as an insurance adjuster and examiner, you typically need to:

• have a high school diploma or equivalent; and
• complete long-term, on-the-job training.

Education after high school

A common way to prepare for this occupation is to receive on-the-job training. Although it is not required, many insurance adjusters and examiners have a bachelor's degree. There is no single program of study that prepares you for this occupation. However, your major may determine the insurance area you work in. For example, those who study architecture or engineering may work with industrial property damage claims.

Work experience

Experience working in a field related to insurance can be excellent preparation for this work. For example, auto damage appraisers often have auto body repair experience. Many examiners are former police officers or detectives. Work experience in an insurance office is also helpful.

On-the-job training

Insurance adjusters and examiners receive training on the job. In many states, adjusters and examiners are licensed. To keep your license you must complete a certain number of hours of education each year. In addition, employers provide training to new adjusters. You typically begin by working on small insurance claims under the direction of an experienced worker. You advance to more complicated and larger claims as you gain experience. Training often lasts one year.

Helpful high school courses

In high school, take classes that prepare you for college. A college preparatory curriculum may be different from your state's graduation requirements.

You should also consider taking some advanced courses in high school. This includes Advanced Placement (AP) and International Baccalaureate (IB) courses if they are available in your school. If you do well in these courses, you may receive college credit for them. Advanced courses can also strengthen your college application.

Helpful electives to take in high school that prepare you for this career include:

• Auto Collision Technology (if you want to handle cases about cars)
• Computer Applications
• Introduction to Health Care (if you want to handle medical cases)

The courses listed above are meant to help you create your high school plan. If you have not already done so, talk to a school counselor or parent about the courses you are considering taking.

You should also check with a teacher or counselor to see if work-based learning opportunities are available in your school and community. These might include field trips, job shadowing, internships, and actual work experience. The goal of these activities is to help you connect your school experiences with real-life work.

Join some groups, try some hobbies, or volunteer with an organization that interests you. By participating in activities you can have fun, make new friends, and learn about yourself. Maybe one of them will help direct you to a future career. Here are examples of activities and groups that may be available in your high school or community.

Things to know

Some employers prefer to hire adjusters and examiners who have a bachelor's degree. No specific college major is required. However, courses in insurance, economics, accounting, and business are helpful. Companies will hire entry-level workers who do not have college training but have related experience. For example, people who have knowledge of auto mechanics or body repair may handle auto claims.

Some states require adjusters and examiners to be licensed. In these states, employers prefer to hire workers who are already licensed. Employers may require adjusters to have a driver's license so they can travel to claimants' homes.

Employers look for adjusters and examiners who have good communication skills. They also look for good research and analysis skills. Basic computer skills are also important.

All employees go through a period of on-the-job training, since each company has a number of procedures that are specific to that company.

Costs to workers

Insurance adjusters and examiners may need to pay licensing costs. Workers may also wish to join a professional association, which may have annual dues. Business attire is usually required when working with clients.

Licensing/certification

Adjusters must be licensed through the office of the Washington State Insurance Commissioner. General licensing requirements include:

• being 18 years of age or older;
• sufficient experience or training with reference to the handling of loss claims under insurance contracts to be considered competent to fulfill the responsibilities of an adjuster;
• a written exam;
• a fingerprint card;
• proof of state residency; and
• 24 hours of continuing education, of which three hours must be on ethics, every two years.

For more licensing and fee information, contact:

Washington State Office of Insurance Commissioner 
PO Box 40255
Olympia, WA 98504-0255
360.725.7144

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Job listings

Listed below are links to job categories from the National Labor Exchange that relate to this career. Once you get a list of jobs, you can view information about individual jobs and find out how to apply. If your job search finds too many openings, or if you wish to search for jobs outside of Washington, you will need to refine your search.

• Claims Examiners, Property and Casualty Insurance 
• Insurance Adjusters, Examiners, and Investigators 

To get a listing of current jobs from the WorkSource system, go to the WorkSource website .

Wages

Wages vary by employer and area of the country. The worker's level of experience, education, and responsibility also affect wages.

Insurance adjusters and examiners who work full time usually receive benefits. Typical benefits include sick leave, paid vacations, and life and health insurance. Some workers also receive profit sharing, bonuses, and retirement plans. Some employers pay for work-related classes. Field adjusters usually have expense accounts and company cars.

Employment and outlook

Washington outlook

The table below provides information about the number of workers in this career in various regions. It also provides information about the expected growth rate and future job openings.

National employment

Major employers:

• Insurance companies
• Insurance agencies
• Business management companies
• State and local government agencies

National outlook

Demand for this occupation will decline due to automation because more claims can be filed online. However, as insurance companies cover more health care procedures, demand will increase. Also new health care laws mean that more people have insurance coverage which will lead to increased health claims. Natural disasters and damage from super storms have also led to increased claims as well.

Job prospects will be best in the health care insurance industry.

Other resources

Insurance Information Institute 
110 William Street
New York, NY 10038
212.346.5500

National Association of Marine Surveyors 
17049 El Camino Real, Suite 208
Houston, TX 77058
800.822.6267
281.480.6267

References

Career cluster

• Finance

Career path

• Conventional (Business Operations)

O*Net  occupations

• Claims Examiners, Property and Casualty Insurance (13-1031.01) 
• Insurance Adjusters, Examiners, and Investigators (13-1031.02) 

O*Net job zones 

• Job Zone 3 - Medium preparation needed. Previous work-related skill, knowledge, or experience is required for these occupations.

• Job Zone 4 - Considerable preparation needed. A minimum of two to four years of work-related skill, knowledge, or experience is needed for these occupations.

DOT occupations

• Claim Adjuster (241.217-010) 
• Claim Agent (191.167-014) 
• Claim Examiner (168.267-014) 
• Claim Examiner (241.267-018) 

Holland occupational clusters

• Conventional/Enterprising/Investigative
• Conventional/Enterprising/Realistic
• Conventional/Enterprising/Social

COPSystem

• Business Skilled