Claims Examiners Property Casualty Insurance Job Description

Adjust reserves and provide reserve recommendations to ensure reserving activities consistent with corporate policies.

Communicate with reinsurance brokers to obtain information necessary for processing claims.

Conduct detailed bill reviews to implement sound litigation management and expense control.

Confer with legal counsel on claims requiring litigation.

Contact and/or interview claimants, doctors, medical specialists, or employers to get additional information.

Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

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.

Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.

Pay and process claims within designated authority level.

Prepare reports to be submitted to company's data processing department.

Present cases and participate in their discussion at claim committee meetings.

Report overpayments, underpayments, and other irregularities.

Resolve complex, severe exposure claims, using high service oriented file handling.

Supervise claims adjusters to ensure that adjusters have followed proper methods.

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.

communicate technical information

compile information through interviews

confer with prosecuting attorney

develop management control systems

direct and coordinate activities of workers or staff

examine documents for completeness, accuracy, or conformance to standards

follow contract, property, or insurance laws

investigate insurance claims

maintain insurance records

maintain records, reports, or files

make presentations

note discrepancies in financial records

obtain information from individuals

prepare reports

recommend claim action

review data on insurance applications or policies

use computers to enter, access or retrieve data

use interviewing procedures

use knowledge of investigation techniques

verify investigative information