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How exposed to AI is a Claims Adjusters, Examiners, and Investigator?

Of the 29 tasks O*NET lists for claims adjusters, examiners, and investigators, 5 could be done in half the time with a chat window today. 6 cannot be sped up at all. Here is which.

Exposure means published research judged an AI could halve the time a task takes, at the same quality. It does not mean the task stops needing a person. How to read this

Also called
Claims AdjusterClaims AnalystClaims ExaminerClaims RepresentativeClaims SpecialistCorporate Claims ExaminerField Claims AdjusterGeneral AdjusterHome Office Claims SpecialistLitigation Claims Representative
Reachable today Needs software built first Cannot be sped up
29
tasks rated for this occupation
60%
hold a degree, from a survey of 40
278k
people do this job in the US
28 of 48
least protected in business and finance

Every task, and what AI can do with it

These are O*NET's task statements for this occupation, exactly as written, sorted into the three bands by the ratings behind this report. Nothing has been reworded.

Reachable with a chat window today

5
  • Examine claims forms and other records to determine insurance coverage
  • Analyze information gathered by investigation and report findings and recommendations
  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation
  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies
  • Prepare reports to be submitted to company's data processing department

Only with software built on top

18
  • 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 ensure that claims are valid and that settlements are made according to company practices and procedures
  • Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability
  • Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims
  • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review
  • Confer with legal counsel on claims requiring litigation
  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments
  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis
  • Refer questionable claims to investigator or claims adjuster for investigation or settlement
  • Collect evidence to support contested claims in court
  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information
  • Present cases and participate in their discussion at claim committee meetings
  • Report overpayments, underpayments, and other irregularities
  • Conduct detailed bill reviews to implement sound litigation management and expense control
  • Examine titles to property to determine validity and act as company agent in transactions with property owners
  • Obtain credit information from banks and other credit services
  • Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit
  • Negotiate claim settlements or recommend litigation when settlement cannot be negotiated

Cannot be sped up

6
  • Pay and process claims within designated authority level
  • Investigate and assess damage to property and create or review property damage estimates
  • Resolve complex, severe exposure claims, using high service oriented file handling
  • Attend mediations or trials
  • Supervise claims adjusters to ensure that adjusters have followed proper methods
  • Communicate with reinsurance brokers to obtain information necessary for processing claims
What this does not say

This is not a prediction about your job

Nobody surveyed an employer. Tasks are counted equally, so a percentage here is a share of the list rather than a share of your week. And the ratings were made in 2023, which makes every figure a floor rather than a ceiling.

It must never be used to select anyone for redundancy. The full limits are here.

Where to go next

This is the standard task list for the title. The useful next question is which of the tasks you actually do should go near AI, and which should not.

Sort your own tasks Read the full report

Exposure ratings from Eloundou, Manning, Mishkin and Rock, GPTs are GPTs: Labor market impact potential of LLMs, Science 384, 1306–1308, 2024, used under the MIT licence. This page includes information from the O*NET Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA), used under the CC BY 4.0 license. O*NET® is a trademark of USDOL/ETA. People Team AI has modified all or some of this information. USDOL/ETA has not approved, endorsed, or tested these modifications. Employment figures from the US Bureau of Labor Statistics.