AI Assistant for Claims Adjusters, Examiners, and Investigators

Core Responsibilities

• 1Examine claims forms and other records to determine insurance coverage.(Core task)
• 2Analyze information gathered by investigation and report findings and recommendations.(Core task)
• 3Pay and process claims within designated authority level.(Core task)
• 4Investigate, 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.(Core task)
• 5Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.(Core task)
• 6Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.(Core task)
• 7Investigate and assess damage to property and create or review property damage estimates.(Core task)
• 8Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.(Core task)
• 9Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.(Core task)
• 10Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.(Core task)

Top Skills Required

Knowledge Areas

Technology & Tools Used

Daily Work Activities

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