Insurance Claims Adjusters
Official O*NET title: Claims Adjusters, Examiners, and Investigators (13-1031.00)
Also called: claims adjuster, claims analyst, claims examiner, claims representative, claims specialist
Do you do this at work?
Answer each card — it takes about a minute.
Do you do this at work?
Analyze information gathered by investigation and report findings and recommendations
Swipe right for yes, left for not me. On a keyboard: → yes, ← not me, Z undo. +2 XP per answer.
How AI is changing insurance claims adjusters work
2 of 20 measurable main tasks for this job show up in real AI-use data, so we rate it Green (little AI use yet) — 10%. 3 newer tasks are not in the data yet and left out.
This shows where people already use AI, not whether the job will disappear. How we measure this.
Tasks in this job and recorded AI use
- Analyze information gathered by investigation and report findings and recommendations (main task) — some recorded AI use
- Examine claims forms and other records to determine insurance coverage (main task) — some recorded AI use
- Pay and process claims within designated authority level (main task) — no recorded AI use
- 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 (main task) — no recorded AI use
- Verify and analyze data used in settling claims to make sure that claims are valid and that settlements are made according to company practices and procedures (main task) — no recorded AI use
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability (main task) — no recorded AI use
- Investigate and assess damage to property and create or review property damage estimates (main task) — no recorded AI use
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims (main task) — no recorded AI use
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review (main task) — no recorded AI use
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation (main task) — no recorded AI use
- Resolve complex, severe exposure claims, using high service oriented file handling (main task) — no recorded AI use
- Adjust reserves or provide reserve recommendations to make sure that reserve activities are consistent with corporate policies (main task) — no recorded AI use
- Talk with legal counsel on claims requiring litigation (main task) — no recorded AI use
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments (main task) — no recorded AI use
- Maintain claim files (main task) — no recorded AI use
- Refer questionable claims to investigator or claims adjuster for investigation or settlement (main task) — no recorded AI use
- Collect evidence to support contested claims in court (main task) — no recorded AI use
- Contact or interview claimants, doctors, medical specialists, or employers to get additional information (main task) — no recorded AI use
- Present cases and participate in their discussion at claim committee meetings (main task) — no recorded AI use
- Report overpayments, underpayments, and other irregularities (main task) — no recorded AI use
- Attend mediations or trials (main task) — too new for the AI data
- Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit (main task) — too new for the AI data
- Negotiate claim settlements or recommend litigation when settlement cannot be negotiated (main task) — too new for the AI data
- Prepare reports to be submitted to company's data processing department — some recorded AI use
- Supervise claims adjusters to make sure that adjusters have followed proper methods — no recorded AI use
- Conduct detailed bill reviews to put in place sound litigation management and expense control — no recorded AI use
- Communicate with reinsurance brokers to obtain information necessary for processing claims — no recorded AI use
- Examine titles to property to determine validity and act as company agent in transactions with property owners — no recorded AI use
- Obtain credit information from banks and other credit services — no recorded AI use
Tasks: O*NET 31.0. AI use: Anthropic Economic Index (exact or close text match).
Your first steps (guidance)
- Week 1: Open a free AI assistant and say hello. Follow our “Getting started with AI” guide. Ask it one simple question about your work.
- Week 2: Use AI on one task you do often. Try the prompt for: “Analyze information gathered by investigation and report findings and recommendations”. Try the prompt for: “Examine claims forms and other records to determine insurance coverage”.
Tick your own tasks above to get a plan based on what you really do. The first 2 weeks are free; Premium (coming soon) adds weeks 3–12. New to AI? Read our beginner’s guide.
Questions about AI and insurance claims adjusters
Will AI replace insurance claims adjusters?
Our data can’t predict job losses, and we don’t try to. What it does show: 2 of the 23 main tasks for this job match tasks people already use AI for (Anthropic Economic Index), giving a Green rating (little AI use yet). Using AI on a task is not the same as AI doing the whole job, and 23 of the 29 listed tasks show no recorded AI use yet.
Which claims adjuster tasks is AI used for most?
In the data, the most AI use among this job’s tasks is for: analyze information gathered by investigation and report findings and recommendations; examine claims forms and other records to determine insurance coverage; prepare reports to be submitted to company's data processing department.
Which claims adjuster tasks show little or no AI use?
For example: 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 make sure that claims are valid and that settlements are made according to company practices and procedures. These are good places to keep building your own skills.
How does this job compare to others?
In Microsoft Research’s “Working with AI” study, this job’s AI applicability score is equal to or higher than 71% of the occupations they scored. That measures overlap with AI chat use, not risk of job loss.
How can a claims adjuster start learning AI?
Start small: open a free AI assistant, try it on one task you do often, and always check facts and numbers yourself. The plan on this page is guidance, not professional advice.
See how this job ranks
Insurance Claims Adjusters ranks #462 of 572 jobs for the share of main tasks with AI use (#1 = most), and #30 of 31 in Finance.
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