A claims adjuster is responsible for investigating, assessing, and resolving insurance claims. They work with customers, insurance companies, and agents to ensure that all claims are handled fairly and in accordance with company policy.
The majority of claims adjusters work for insurance companies, although some may work for third-party claim processing companies. They typically have a college degree in business, economics, accounting, or a related field.
Sample job description
We seeking a highly motivated claims adjuster to join our team. Claims adjusters establish the business parameters of each claim by analyzing customer applications, company guidelines, laws/regulations, and cost-effectiveness. They also interpret computerized data systems to determine the scope of coverage available for losses that may occur within a policy or aggregate policy, identify covered properties, and assess risk. The responsibilities of claims adjusters include evaluating, investigating, and resolving claims according to company policy and state laws, establishing business parameters of every claim, communicating with customers throughout the claims process, and monitoring claims for possible fraud and misrepresentation. As a claims adjuster, you’ll be responsible for helping customers get back on the road after an accident. You’ll have the support of a collaborative team and ongoing coaching from leaders.
Typical duties and responsibilities
- Investigate insurance claims and determine if the insurance company should pay the claim
- Review medical records, police reports, and other documents related to the claim
- Determine the value of a claim and whether the insurance company should pay for damages, medical expenses, or other losses
- Prepare reports on their findings and make recommendations to the insurance company
- Negotiate with claimants to reach a settlement
- Represent the insurance company in court proceedings if a claim goes to trial
Education and experience
- A college degree is not required for this job, but some insurance companies may prefer to hire claims adjusters with a degree in business, economics, mathematics, or a related field
- Claims adjusters typically have at least three years of experience investigating insurance claims
- The ability to investigate each claim thoroughly and accurately
- They must be able to communicate effectively with claimants, witnesses, lawyers, insurance company representatives, doctors, and other professionals
Required skills and qualifications
- Thorough knowledge of insurance claims process
- Investigative skills
- Strong communication and negotiation skills
- Problem-solving skills
- Ability to work independently
- Ability to travel around the state
Preferred qualifications
- Bilingual abilities
- Familiarity with computers and software applications used in investigations, including databases and specific claims software programs
- Strong negotiation skills are important for this job
- They should have good problem-solving skills since claims can become very complicated
- Experience in the insurance industry is helpful, but not always necessary, as many claims adjusters come from a customer service background
Average salary and compensation
The average salary for a claims adjuster is $50,850. They may receive additional pay for overtime or travel. They may also receive a benefits package, which includes health insurance, dental insurance, and a 401(k) plan.
| Location | Salary Low | Salary High |
|---|---|---|
| Phoenix, Arizona | $50,550 | $68,400 |
| Los Angeles, California | $57,050 | $77,200 |
| Denver, Colorado | $47,550 | $64,350 |
| Washington, DC | $57,900 | $78,350 |
| Miami, Florida | $47,350 | $64,050 |
| Orlando, Florida | $43,650 | $59,050 |
| Tampa, Florida | $44,100 | $59,650 |
| Atlanta, Georgia | $46,250 | $62,550 |
| Chicago, Illinois | $53,150 | $71,950 |
| Boston, Massachusetts | $57,500 | $77,800 |
| Minneapolis-St. Paul, Minnesota | $45,800 | $62,000 |
| New York City, New York | $60,500 | $81,850 |
| Philadelphia, Pennsylvania | $49,250 | $66,650 |
| Dallas, Texas | $48,000 | $64,900 |
| Houston, Texas | $47,550 | $64,350 |
| Seattle, Washington | $55,350 | $74,850 |
| National Average | $43,200 | $58,500 |
Typical work environment
Claims adjusters typically work in an office setting. They may have to travel, sometimes overnight, to meet with claimants or insurance company representatives. They may also negotiate with claimants by phone. The job of a claims adjuster can be very challenging, but it can also be very rewarding. They play an important role in the insurance industry, and their work can have a direct impact on the claimants they work with. Claims adjusters must have good investigative skills, strong communication skills, and the ability to negotiate settlements.
Typical hours
This is a full-time job, and the hours can be long. Claims adjusters may have to work overtime to meet deadlines or resolve complex claims. They may also have to travel to meet with claimants or insurance company representatives.
Available certifications
There are a few certifications available for claims adjusters. However, this is the most popular one:
- AdjusterPro Claims Adjuster License. This online pre-licensing course includes an online state exam and satisfies all state requirements. No additional coursework or testing is needed. Offered 100% online, our program allows you to complete your training anywhere, anytime.
Career path
A claims adjuster’s career path can vary depending on your level of experience, education, and certifications. Many insurance companies prefer to hire candidates with an undergraduate degree in finance, business, or insurance, so you will most likely need to go to college and earn a degree in one of these related fields.
US, Bureau of Labor Statistics’ job outlook
SOC Code: 13-1030
| 2020 Employment | 349,400 |
| Projected Employment in 2030 | 340,500 |
| Projected 2020-2030 Percentage Shift | 3% decrease |
| Projected 2020-2030 Numeric Shift | 8,900 decrease |
Position trends
Claims adjusters evaluate the extent of an insurance company’s liability for personal and property damage, illness, or other loss. As a result, claims adjusters work to protect the profitability of their organization by minimizing payouts on claims while ensuring that legitimate claims are paid promptly and in full. In general, claims adjusters work under the supervision of a supervisor, who may be a manager, supervisor, or claims examiner.
As more insurance policies are written and businesses contract to cover their property and liability risks, the number of claims will inevitably rise. The need for qualified claims adjusters will also increase as companies hire staff or outsource this function to third parties.
The US Bureau of Labor Statistics projects that the employment of claims adjusters, examiners, and investigators will decrease by 3% from 2020 to 2030. This projected decline is slower than the average for all occupations.
Sample interview questions
- What types of customers have you worked with in the past?
- How comfortable are you with approaching customers on the phone?
- Have you had to use your negotiation skills while working for a previous employer? How did it go?
- How do you feel about working overtime or traveling overnight when necessary?
- Do you think that your previous experience qualifies you to work as a claims adjuster? If not, what would you need to do to be qualified?
- What education and/or experience do you have in the insurance industry?
- What was the most difficult claim that you ever had to investigate and why?
- What is your understanding of the insurance claims process?
- If you were hired as a claims adjuster, what do you think would be your biggest challenge?
- Have you ever had to file a claim with an insurance company? If so, how was the process for you?
- What is your understanding of the insurance adjuster’s role in the industry?
