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Property and Casualty Insurance Claims Examiner

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What is a Property and Casualty Insurance Claims Examiner?

Insurance Claims Examiner Definition 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.

What Do Property and Casualty Insurance Claims Examiners Do On a Daily Basis?

  • Supervise claims adjusters to ensure that adjusters have followed proper methods.
  • Communicate with reinsurance brokers to obtain information necessary for processing claims.
  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
  • 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.
  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
  • Conduct detailed bill reviews to implement sound litigation management and expense control.

Things an Insurance Claims Examiner Should Know How to Do

Property and Casualty Insurance Claims Examiners state the following job skills are important in their day-to-day work.

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.

Speaking: Talking to others to convey information effectively.

Critical Thinking: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.

Negotiation: Bringing others together and trying to reconcile differences.

  • Check Examiner
  • Workers Compensation Claims Examiner
  • Liability Claims Manager
  • Claims Representative
  • Claims Auditor

Insurance Claims Examiner Job Outlook

In the United States, there were 311,100 jobs for Property and Casualty Insurance Claims Examiner in 2016. There is little to no growth in job opportunities for Property and Casualty Insurance Claims Examiner. The BLS estimates 24,500 yearly job openings in this field.

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The states with the most job growth for Insurance Claims Examiner are Utah, Arizona, and Colorado. Watch out if you plan on working in Maine, District of Columbia, or Mississippi. These states have the worst job growth for this type of profession.

Salary for an Insurance Claims Examiner

The salary for Property and Casualty Insurance Claims Examiners ranges between about $39,620 and $98,660 a year.

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Property and Casualty Insurance Claims Examiners who work in Connecticut, Massachusetts, or New Jersey, make the highest salaries.

Below is a list of the median annual salaries for Property and Casualty Insurance Claims Examiners in different U.S. states.

State Annual Mean Salary
Alabama $65,060
Alaska $73,370
Arizona $67,340
Arkansas $61,930
California $71,720
Colorado $72,460
Connecticut $78,590
Delaware $63,440
District of Columbia $74,210
Florida $62,840
Georgia $65,430
Hawaii $62,860
Idaho $63,020
Illinois $65,980
Indiana $63,480
Iowa $62,750
Kansas $67,570
Kentucky $55,820
Louisiana $66,440
Maine $60,980
Maryland $72,050
Massachusetts $76,150
Michigan $67,860
Minnesota $65,760
Mississippi $62,700
Missouri $66,340
Montana $55,970
Nebraska $61,050
Nevada $65,510
New Hampshire $71,190
New Jersey $74,260
New Mexico $63,890
New York $71,950
North Carolina $62,580
North Dakota $58,580
Ohio $65,890
Oklahoma $61,670
Oregon $67,750
Pennsylvania $67,730
Rhode Island $71,950
South Carolina $62,950
South Dakota $61,490
Tennessee $60,550
Texas $69,560
Utah $59,330
Vermont $66,240
Virginia $63,640
Washington $72,340
West Virginia $57,030
Wisconsin $63,420
Wyoming $65,300

Tools & Technologies Used by Property and Casualty Insurance Claims Examiners

Below is a list of the types of tools and technologies that Property and Casualty Insurance Claims Examiners may use on a daily basis:

  • Microsoft Excel
  • Microsoft Word
  • Microsoft Office
  • Microsoft PowerPoint
  • Microsoft Publisher
  • Medical procedure coding software
  • Healthcare common procedure coding system HCPCS
  • Medical condition coding software
  • Document management system software
  • Hyland OnBase Enterprise Content Management
  • Axonwave Fraud and Abuse Management System
  • StrataCare StrataWare eReview
  • LexisNexis RiskWise
  • CCC Pathways Appraisal Quality Solution
  • ISO NetMap for Claims
  • ISO ClaimSearch
  • IBM Fraud and Abuse Management System
  • Hummingbird Legal Bill Review
  • Agency Management Systems AMS 360
  • AutoClaims Direct DirectLink

How to Become an Insurance Claims Examiner

Are there Property and Casualty Insurance Claims Examiners education requirements?

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How Long Does it Take to Become an Insurance Claims Examiner?

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Where Property and Casualty Insurance Claims Examiners Work

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The table below shows the approximate number of Property and Casualty Insurance Claims Examiners employed by various industries.

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You May Also Be Interested In…

Those thinking about becoming a Property and Casualty Insurance Claims Examiner might also be interested in the following careers:

Those who work as a Property and Casualty Insurance Claims Examiner sometimes switch careers to one of these choices:

References:

Image Credit: Nick Youngson via Creative Commons 3 - CC BY-SA 3.0

More about our data sources and methodologies.

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