Insurance Adjusters and Claims Examiners (NOC 1233)
Description
Insurance adjusters investigate insurance claims and determine the amount of loss or damages covered by insurance policies. They are employed in claims departments of insurance companies or as independent adjusters. Insurance claims examiners examine claims investigated by insurance adjusters and authorize payments. They are employed at head offices or branches of insurance companies.
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Example Titles
- adjuster
- claims examiner
- claims representative
- insurance adjuster
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Classified Elsewhere
- Supervisors, Finance and Insurance Clerks (1212)
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Duties
Insurance adjusters perform some or all of the following duties:
- Investigate circumstances surrounding insurance claims to determine validity of claim
- Inspect automobile, home or other property damage
- Take statements and consult with claimants, accident witnesses, doctors and other relevant individuals and examine records or reports
- Determine amount of loss or damages covered by insurance policies
- Negotiate settlement of claims
- Prepare adjustment reports.
Insurance claims examiners perform some or all of the following duties:
- Review, examine, calculate and authorize insurance claims investigated by insurance adjusters
- Examine adjuster's reports and similar insurance claims or precedents to determine extent of insurance coverage
- Ensure claims are valid and settlements are made according to company practices and procedures
- Consult lawyers, doctors or other relevant individuals to discuss insurance claims
- Approve automobile, fire, life, disability, dental or other insurance claims.
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Skills
Insurance claims adjusters and investigators need the following skills and abilities:
- an interest in investigation and analytical ability,
- strong oral and written communication skills,
- strong organizational and time management skills,
- computer skills, including word processing,
- be able to work independently,
- enjoy working within a set of rules and policies,
- be able ability to remain calm and impartial when dealing with people who are excited or under stress,
- ability to put claimants at ease,
- enjoy working with detail, evaluating information, working with numbers,
- investigators may need to be creative and/or aggressive in obtaining information,
- the ability to work on several projects at the same time,
- out-of-office investigators may require a drivers license.
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Employment Requirements
- In Manitoba, completion of secondary school is required. Several years of on-the-job training and completion of insurance industry courses and training programs are required.
- Insurance Agents/Brokers, Independent Insurance Adjusters, and Life and Accident and Sickness Insurance Agents require a licence from the Insurance Council of Manitoba.
- Insurance Agent/Broker License - There are 3 levels of licensing with specific requirements and restrictions, with an examination at each level.
- Independent Insurance Adjusters License -There are 5 levels of licensing with specific requirements and restrictions, with an examination at each level.
- Life and Accident and Sickness Insurance Agents License - Successful completion of an approved Life License Qualification Program (LLQP) and an examination are required.
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Terms & Conditions
Insurance adjusters and claims examiners commonly work in a computerized office environment as well as outside. They routinely leave the office in order to meet with clients, investigate insurance claims, or view damaged property, and may occasionally work evenings or weekends. Most insurance adjusters and claims examiners work full-time (97%). Almost all are salaried employees (99%).
Senior claims examiners can earn more than adjusters depending on the complexity of the claim being reviewed. Staff adjusters are normally paid a monthly salary, while independent adjusters are usually paid a fee for their services. Earnings, for independent adjusters, fluctuate and they may earn as much as $100,000 during years when there are occurrences of natural disasters such as floods and hail damage.
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Earnings
$27,500 per annum - starting
$47,600 per annum - average
$66,000 per annum - high
Earnings are reviewed annually or more frequently if new information becomes available.
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Education / Training
- The Financial Advisors Association of Canada, Canadian Securities Institute, Institute of Canadian Bankers, and the Insurance Institute of Canada all offer a Life License Qualification Program (LLQP) approved by the Insurance Council of Manitoba.
- The Insurance Institute of Manitoba offers the CIP (Certified Insurance Professional) Program. The Institute also offers the Associate Customer Service (ACS) Program, which can be taken by correspondence or through designated post-secondary institutions.
- The Insurance Council of Manitoba provides a list of pre-approved training providers.
- Some high schools in Manitoba offer a program in Business Education.
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Career Paths
Insurance adjusters often begin as clerical workers or telephone adjusters in the claims departments of insurance companies or in independent adjusting firms, and through informal learning obtain enough knowledge to be hired as adjusters. To advance to senior levels, specific courses are required.
Insurance adjusters may also find jobs as claims examiners, field adjusters, supervisors or claims managers. Adjusters with sales ability may become insurance salespersons. Those with financial skills may become underwriters.
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Outlook
Employment prospects for insurance adjusters and claims examiners are expected to be good in the 2010 to 2014 period. Employment in Manitoba is estimated at 1,240 in 2010.
Insurance adjusters operate in an increasingly competitive environment. Insurance companies are continually offering new products in response to the changing needs of society. An aging population will require more health and long term care insurance options. The growing use of the internet for business and personal use will increase the need for new insurance products to cover risks such as identity theft. While technology has provided some tools and automated some of the functions of insurance adjusters and claims examiners, many claims still require personal assessment and adjudication.
A proportionally larger number of jobs for insurance adjusters and claims examiners are located in Winnipeg. The majority of positions are in the Finance and Insurance industry (89%), followed by Public Administration (6%).
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Employment by Age Group
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Employment by Industry
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Employment by Region
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Employment by Gender
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Employment by Aboriginal Self-Identification
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Employment by Visible Minority
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Please Note - The source for above charts is the 2006 Census.
Professional Associations, Unions, and Regulatory Bodies...
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