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TASK
Claims Adjusters, Examiners, and Investigators
ID
work_business_financial/claims_adjusters_examiners_and_investigators
Type
TASK
Children
29
Child Nodes (29)
ATOMIC
Examine claims forms and other records to determine insurance coverage.
ATOMIC
Analyze information gathered by investigation and report findings and recommendations.
ATOMIC
Pay and process claims within designated authority level.
ATOMIC
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.
ATOMIC
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.
ATOMIC
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
ATOMIC
Investigate and assess damage to property and create or review property damage estimates.
ATOMIC
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
ATOMIC
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
ATOMIC
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
ATOMIC
Resolve complex, severe exposure claims, using high service oriented file handling.
ATOMIC
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
ATOMIC
Confer with legal counsel on claims requiring litigation.
ATOMIC
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
ATOMIC
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
ATOMIC
Refer questionable claims to investigator or claims adjuster for investigation or settlement.
ATOMIC
Collect evidence to support contested claims in court.
ATOMIC
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
ATOMIC
Present cases and participate in their discussion at claim committee meetings.
ATOMIC
Report overpayments, underpayments, and other irregularities.
ATOMIC
Attend mediations or trials.
ATOMIC
Supervise claims adjusters to ensure that adjusters have followed proper methods.
ATOMIC
Conduct detailed bill reviews to implement sound litigation management and expense control.
ATOMIC
Communicate with reinsurance brokers to obtain information necessary for processing claims.
ATOMIC
Prepare reports to be submitted to company's data processing department.
ATOMIC
Examine titles to property to determine validity and act as company agent in transactions with property owners.
ATOMIC
Obtain credit information from banks and other credit services.
ATOMIC
Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.
ATOMIC