Claims Adjusters, Appraisers, Examiners, and Investigators


Quick Facts: Claims Adjusters, Appraisers, Examiners, and Investigators
2017 Median Pay $64,690 per year 
$31.10 per hour
Typical Entry-Level Education  
Work Experience in a Related Occupation None
On-the-job Training  
Number of Jobs, 2016 328,700
Job Outlook, 2016-26 -1% (Little or no change)
Employment Change, 2016-26 -3,600

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Claims Adjusters, Appraisers, Examiners, and Investigators Career, Salary, and Education Information

What Claims Adjusters, Appraisers, Examiners, and Investigators Do

Claims adjusters, appraisers, examiners, and investigators evaluate insurance claims. They decide whether an insurance company must pay a claim and if so, how much.

claim adjuster.png

Claims ADJUSTERS

 

Duties of Claims Adjusters, Appraisers, Examiners, and Investigators

Claims adjusters, appraisers, examiners, and investigators typically do the following:

  • Investigate, evaluate, and settle insurance claims

  • Determine whether the insurance policy covers the loss claimed

  • Decide the appropriate amount the insurance company should pay

  • Ensure that claims are not fraudulent

  • Contact claimants’ doctors or employers to get additional information on questionable claims

  • Confer with legal counsel on claims when needed

  • Negotiate settlements

  • Authorize payments

Claims adjusters, appraisers, examiners, and investigators have varying duties, depending on the type of insurance company they work for. They must know a lot about what their company insures. For example, workers in property and casualty insurance must know housing and construction costs in order to properly evaluate damage from floods or fires. Workers in health insurance must be able to determine which types of treatments are medically necessary and which are questionable.

Adjusters inspect property damage or personal injury claims to determine how much the insurance company should pay for the loss. They might inspect a home, a business, or an automobile.

Appraisers estimate the cost or value of an insured item. Most appraisers who work for insurance companies and independent adjusting firms are auto damage appraisers. They inspect damaged vehicles after an accident and estimate the cost of repairs. This information then goes to the adjuster, who puts the estimated cost of repairs into the settlement.

Claims examiners review claims after they are submitted to ensure claimants and adjusters followed proper guidelines. They may assist adjusters with complicated claims or when, for example, a natural disaster occurs and the volume of claims increases.

Insurance investigators handle claims in which the company suspects fraudulent or criminal activity such as arson, staged accidents, or unnecessary medical treatments. The severity of insurance fraud cases varies, from overstated claims of damage to vehicles to complicated fraud rings. Investigators often do surveillance work.


Work Environment for Claims Adjusters, Appraisers, Examiners, and Investigators

Claims adjusters, examiners, and investigators held about 311,100 jobs in 2016. The largest employers of claims adjusters, examiners, and investigators were as follows:

Direct insurance (except life, health, and medical) carriers: 32%

Agencies, brokerages, and other insurance related activities: 25%

Government: 19%

Direct health and medical insurance carriers: 8%

Administrative and support services: 3%

 

Insurance appraisers, auto damage held about 17,600 jobs in 2016. The largest employers of insurance appraisers, auto damage were as follows:

Direct insurance (except life, health, and medical) carriers: 73%

Agencies, brokerages, and other insurance related activities: 18%

Self-employed workers: 2%

Professional, scientific, and technical services: 2%

Management of companies and enterprises: 1%

Work Schedules

Most claims adjusters, appraisers, examiners, and investigators work full time. However, their work schedules vary. Adjusters often arrange their work schedules to accommodate evening and weekend appointments with clients. This requirement sometimes results in adjusters working irregular schedules, especially when they have a lot of claims to review.


How to Become a Claims Adjusters, Appraisers, Examiners, and Investigators

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster, examiner, or investigator, although some positions may require a bachelor’s degree or insurance-related work experience. Auto damage appraisers typically have either a postsecondary nondegree award or previous work experience in identifying and estimating the cost of automotive repair.

Education

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster or examiner. However, employers sometimes prefer to hire applicants who have a bachelor’s degree or some insurance-related work experience.

For investigator jobs, a high school diploma or equivalent is the typical education requirement. Some insurance companies prefer to hire people trained as law enforcement officers or private investigators, because these workers have good interviewing and interrogation skills.

Auto damage appraisers typically have either a postsecondary nondegree award or experience working in an auto repair shop, identifying and estimating the cost of automotive repair. Many vocational schools and some community colleges offer programs in auto body repair and teach students how to estimate the cost of repairing damaged vehicles.

Training

At the beginning of their careers, claims adjusters, examiners, and investigators work on small claims under the supervision of an experienced worker. As they learn more about claims investigation and settlement, they are assigned larger, more complex claims.

Auto damage appraisers typically get on-the-job training, which may last several months. This training usually involves working under the supervision of a more experienced appraiser while estimating damage costs, until the employer decides that the trainee is ready to do estimates on his or her own.

Licenses, Certifications, and Registrations

Licensing requirements for claims adjusters, appraisers, examiners, and investigators vary by state. Some states have few requirements; others require either completing prelicensing education or receiving a satisfactory score on a licensing exam (or both).

In some states, claims adjusters employed by insurance companies do not have to become licensed themselves because they can work under the company license.

Public adjusters may need to meet separate or additional requirements.

Some states that require licensing also require a certain number of continuing education credits per year to renew the license. Federal and state laws and court decisions affect how claims must be handled and what insurance policies can and must cover. Examiners working on life and health claims must stay up to date on new medical procedures and the latest prescription drugs. Examiners working on auto claims must be familiar with new car models and the most recent repair techniques. In order to fulfill their continuing education requirements, workers can attend classes or workshops, write articles for claims publications, or give lectures and presentations.

Important Qualities

Analytical skills. Adjusters and examiners must each evaluate whether the insurance company is obligated to pay a claim and determine the amount to pay. Adjusters must carefully consider various pieces of information to reach a decision.

Communication skills. Claims adjusters and investigators must get information from a wide range of people, including claimants, witnesses, and medical experts. They must know the right questions to ask in order to gather the information they need.

Detail oriented. Adjusters, appraisers, examiners, and investigators must carefully review documents and damaged property, because small details can have large financial consequences.

Interpersonal skills. Adjusters, examiners, and investigators often meet with claimants and others who may be upset by the situation that requires a claim or by the settlement the company is offering. These workers must be understanding, yet firm with their company’s policies.

Math skills. Appraisers must be able to calculate property damage.


salaries for Claims Adjusters, Appraisers, Examiners, and Investigators

The median annual wage for claims adjusters, examiners, and investigators was $64,900 in May 2017. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $38,930, and the highest 10 percent earned more than $97,080.

In May 2017, the median annual wages for claims adjusters, examiners, and investigators in the top industries in which they worked were as follows:

Government: $72,230

Direct insurance (except life, health, and medical) carriers: $64,810

Agencies, brokerages, and other insurance related activities: $62,590

Direct health and medical insurance carriers: $59,600

Administrative and support services: $45,160

 

In May 2017, the median annual wages for insurance appraisers, auto damage in the top industries in which they worked were as follows:

Direct insurance (except life, health, and medical) carriers: $63,260

Management of companies and enterprises: $62,510

Agencies, brokerages, and other insurance related activities: $59,160

Professional, scientific, and technical services: $56,810


Job Outlook for Claims Adjusters, Appraisers, Examiners, and Investigators

Overall employment of claims adjusters, appraisers, examiners, and investigators is projected to show little or no change from 2016 to 2026.

Employment of claims adjusters, examiners, and investigators is projected to decline 1 percent from 2016 to 2026. Technology is expected to automate some of the tasks currently performed by adjusters. For instance, computer software can evaluate photographs of damaged property and calculate an estimated claim amount. In addition, data collection and processing speed will increase, which will improve efficiency and allow more work to be done with fewer adjusters.

Job Prospects

Job opportunities for claims adjusters and examiners should be best in firms providing services related to insurance, such as insurance claims adjusting companies. In addition, prospects for claims adjusters in property and casualty insurance will likely be best in areas susceptible to natural disasters. These areas include the Gulf Coast, which can have a large number of hurricanes, and the West Coast, which is vulnerable to wildfires.

Employment projections data for Claims Adjusters, Appraisers, Examiners, and Investigators, 2016-2026:

Employment, 2016: 328,700

Projected Employment, 2026: 325,100

Change, 2016-2026: -1%, -3,600


Careers Related to claims adjusters, appraisers, examiners, and investigators

Appraisers and Assessors of Real Estate

Appraisers and assessors of real estate provide a value estimate on land and buildings usually before they are sold, mortgaged, taxed, insured, or developed.

Automotive Body and Glass Repairers

Automotive body and glass repairers restore, refinish, and replace vehicle bodies and frames, windshields, and window glass.

Automotive Service Technicians and Mechanics

Automotive service technicians and mechanics, often called service technicians or service techs, inspect, maintain, and repair cars and light trucks.

Construction and Building Inspectors

Construction and building inspectors ensure that construction meets local and national building codes and ordinances, zoning regulations, and contract specifications.

Cost Estimators

Cost estimators collect and analyze data in order to estimate the time, money, materials, and labor required to manufacture a product, construct a building, or provide a service. They generally specialize in a particular product or industry.

Fire Inspectors

Fire inspectors examine buildings in order to detect fire hazards and ensure that federal, state, and local fire codes are met. Fire investigators, another type of worker in this field, determine the origin and cause of fires and explosions. Forest fire inspectors and prevention specialists assess outdoor fire hazards in public and residential areas.

OccupationENTRY-LEVEL EDUCATION2017 MEDIAN PAY
Appraisers and Assessors of Real EstateBachelor's degree$54,010
Automotive Body and Glass RepairersHigh school diploma or equivalent$40,580
Automotive Service Technicians and MechanicsPostsecondary nondegree award$39,550
Construction and Building InspectorsHigh school diploma or equivalent$59,090
Cost EstimatorsBachelor's degree$63,110
Fire Inspectors$56,670

Citation:

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Claims Adjusters, Appraisers, Examiners, and Investigators, on the Internet at https://www.bls.gov/ooh/business-and-financial/claims-adjusters-appraisers-examiners-and-investigators.htm