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 at the level of the job family, Management and business operations:
- Task levelPartialOnly adjacent evidence. On TheAgentCompany, which gives agents workplace tasks inside a simulated software company, the best agent resolves 42.9% of tasks (a November 2025 result). No task-level benchmark in our collection maps directly to management or business operations.
- Project levelPartialMixed. OpenAI reports that GPT-5.5's GDPval deliverables won or tied against professionals' work in 84.9% of comparisons, and the best agent passes 73.5% of APEX-Agents tasks on the first try. Running a business is weaker: on Vending-Bench 2 the best model ends a simulated year with $15,515, about a quarter of Andon Labs' estimate for a good strategy.
Benchmarks for the job family
These cover work in management and business operations, not always this occupation's tasks.
- 1846 EloClaude Opus 5.5 (Adaptive Reasoning, Max Effort, Default Fallback) · 23 Sep 2026Unrated
- 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