Insurance Claims Representative Job Description

Insurance protects you against financial loss when an unforeseen event or accident occurs. Injuries, illnesses, deaths and property damage happen every day. If you have insurance and you've suffered from one of these events, you can claim financial compensation from your insurance company. Insurance claims representatives investigate these claims and determine how much money the client is owed.

  1. Job Description

    • Insurance claims representatives spend most of their time investigating claims made against an insurance company. It's up to the claims representative to determine the validity of a claim by investigating the circumstances. They must gather information on what happened to estimate the damages. Based on investigation and research, the insurance claims representative will accept the claim, deny it, or negotiate a settlement between the claimant and the company. Claims representatives protect the company against fraudulent claims while settling valid claims quickly and fairly.

    Duties

    • The duties all focus around investigations. The claims representative is responsible for inspecting the damage to insured property; taking written statements from those involved; and consulting with the claimants, witnesses, doctors and any others with relevant information. The claims representative must read police reports and medical records, examine diagrams and photos, and consult with lawyers, if any are involved. After she's pieced together all of the available information, the claims representative will write a final report detailing her findings and decision.

    Working Conditions

    • Most insurance claims representatives work for insurance companies, but some are self-employed and work on a contract basis. Most work eight hours a day, five days a week, but sometimes overtime is required if an investigation is unusually complicated or involves meeting with claimants or witnesses after hours. Claims representatives work in an office environment but spend time traveling to appointments and interviews. Interviews with claimants are usually conducted in the claimant's home. Claims representatives also occasionally visit potentially dangerous locations, such as a burned-out house, to conduct an investigation.

    Earnings

    • Claims representatives employed by an insurance company receive an annual salary, while those who are self-employed work from contract to contract. Earnings vary depending on location, level of experience and employer. According to the Bureau of Labor Statistics, insurance claims representatives earned $25,000 to $100,000 in 2008. Those who work for an insurance company usually have health insurance, paid sick time, and paid vacation as well. Many also have access to a company car because of the amount of driving they do while conducting an investigation.

    Education

    • To be an insurance claims representative, you must at least have a high school diploma. Most claims representatives have gone to college for business, insurance studies or risk-management studies. There are two-year and four-year programs available in all of these subjects. In addition, claims representatives should have strong math skills, the ability to work independently, a familiarity with legal and medical terminology, and basic computer skills. A valid driver's license is often required.

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References

  • Photo Credit office image by Yvonne Bogdanski from Fotolia.com

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