Job Profile of a Claims Investigator

Insurance companies have their own insurance claims investigator to investigate claims made by policy holders.

A claims Investigator’s job description would usually entail the following:

Insurance Claims investigators gather background information of claimants and witnesses from the database.
Investigators may make personal visits to claimants and witnesses for any gathering information.
Investigators often undertake surveillance work to bring out facts about any claims.
They visit places of accident or loss for uncovering facts
They negotiate with claimants to make settlements
They develop connections with other legal or claims professionals
If they suspect fraudulent activity they may access personal information of claimants and witnesses like social security numbers, addresses, and phone numbers and so on to search for any history of insurance fraud.

On the event of questionable claims, they work with expert witnesses and attorneys to defend the company’s position.

Careers of a Claims Investigator may range from being an adjuster, an examiner, an appraiser and an investigator of claims made by policy holders. Although each of these has a different job profile, yet in many cases they are found to be having overlapping functions.

Usually employed by the property or casualty insurance companies, their jobs can be broadly divided in the following three categories;

Investigation of Claims

1. Negotiation
2. Settlement or Authorization of payments

In other words, an insurance claims investigator’s job is to determine whether or not the client’s policy covers the damages and how much is to be paid to the claimant.

Today businesses and individuals both need insurance coverage for protection of their assets and finances. There are a host of property, casualty, medical and life insurance companies in operation. In view of this, insurance claim investigator careers have immense growth potentials.

If you wish to be a part of the insurance industry then you must possess a logical mind with good numeracy and literacy skills, an outgoing and confident personality and above all negotiation skills. The job involves considerable travelling within the day to clients, witnesses, solicitors and other professionals. Most companies provide on the job training to the prospective claims investigators.