Jobs / Management and business operations / 13-1031.00
Claims Adjusters, Examiners, and Investigators
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
- US jobs
- 324,230
- Median wage
- $78,000 a year
- Job family
- Management and business operations
Can agents do the work of claims adjusters, examiners, and investigators?
We read the evidence for the whole job family, Management and business operations: Some tasks (first measured in the last 12 months)
Agents complete 20% or more of the tasks (or projects) on a direct benchmark.
Evidence: SOP-Bench, 72.4% of tasks completed.
16% of this occupation's work, by O*NET work activities, is measured by a direct benchmark.
- 15%Investigate criminal or legal mattersNot measured
- 13%Interview people to obtain informationNot measured
- 7%Communicate with others about operational plans or activitiesMeasured
- 6%Evaluate the quality or accuracy of dataNot measured
- 5%Analyze data to improve operationsNot measured
- 5%Determine values or prices of goods or servicesNot measured
- 5%Maintain operational recordsMeasured
- 4%Execute financial transactionsNot measured
Benchmarks for the job family
These cover work in management and business operations, not always this occupation's tasks.
Direct evidence
Work benchmarks mapped primary to this family. They set the step when they report how many tasks agents complete.
Also relevant
These benchmarks cover part of this family's work, or have no result yet. They do not set its step.
- 45.9%Claude Opus 4.6 · 16 Mar 2026Emerging
- 64.8%Claude Code + Opus 5.5 (max) · 6 Oct 2026Strong
Context only
These benchmarks span many occupations, or they test how agents behave. They give context but do not set the step.
- 42.9%TTE-MatrixAgent + DeepSeek-V3.2 · 10 Nov 2025Emerging
Typical tasks
From O*NET 31.0. Core tasks first. Few of these tasks have a benchmark today.
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- Pay and process claims within designated authority level.
- 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.
- 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.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Investigate and assess damage to property and create or review property damage estimates.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
- Resolve complex, severe exposure claims, using high service oriented file handling.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Other job titles for this occupation (72)
Claims Adjuster · Claims Analyst · Claims Examiner · Claims Representative · Claims Specialist · Corporate Claims Examiner · Field Claims Adjuster · General Adjuster · Home Office Claims Specialist · Litigation Claims Representative · Accident Investigator · Adjuster · Adjustment Clerk · Auto Claims Adjuster (Automotive Claims Adjuster) · Auto Damage Claims Adjuster (Automotive Damage Claims Adjuster) · Benefit Authorizer · Bodily Injury Claims Adjuster · Bodily Injury Claims Examiner · Claims Account Specialist · Claims Adjustor · Claims Agent · Claims Approver · Claims Auditor · Claims Consultant · Claims Inspector · Claims Investigator · Claims Processor · Claims Service Adjustor · Claims Service Specialist · Clerical Adjuster · Commercial Insurance Inspector · Compensation Adjuster · Disability Analyst · Disability Examiner · Disability Specialist · Field Investigator · Field Liability Generalist · Field Property Claims Adjuster · Field Property Claims Specialist · Fire Adjuster · Fire Claims Adjuster · Health Claims Examiner · Health Insurance Adjuster · Home Office Claims Examiner · Independent Insurance Adjuster · Independent Insurance Agent · Insurance Adjuster · Insurance Appraiser · Insurance Auditor · Insurance Claims Adjuster · Insurance Examiner · Insurance Fraud Investigator · Insurance Inspector · Investigator · Liability Claims Examiner · Liability Claims Representative · Litigation Examiner · Medical Claims Analyst · Medical Claims Examiner · Medical Claims Specialist · Professional Liability Claims Specialist · Property Adjuster · Property and Casualty Insurance Claims Examiner · Property Claims Adjuster · Property Damage Claims Adjustor · Reinsurance Claims Analyst · Residential Insurance Inspector · Salvage Determiner · Workers' Compensation Claims Adjuster · Workers' Compensation Claims Examiner · Workers' Compensation Claims Representative · Workers' Compensation Examiner