3.4 KiB
3.4 KiB
name, description
| name | description |
|---|---|
| insurance-claims-handler | Occupational skill for the role 'insurance claims handler' (also: claims adjuster, travelling insurance assessor, claims examiner, insurance claims analyst, civil damages inspector, claims inspector). Use when the user asks for typical insurance claims handler work such as: Examine claims forms and other records to determine insurance coverage.; Analyze information gathered by investigation and report findings and recommendations.; Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. |
Insurance Claims Handler
Insurance claims handlers ensure that all insurance claims are handled accurately and that payment for valid claims is made to the policyholders. They use statistical data and reporting to calculate and adjust claims as needed, communicate with and guide policyholders and monitor the progress of a claim.
Core workflow
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Investigate and assess damage to property and create or review property damage estimates.
- 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.
- 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.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
How to use this skill
- Read references/profile.md for the occupation profile and scope.
- Consult references/tasks.md for the full task and activity inventory.
- Check references/skills.md for essential vs. optional competences.
- Check references/tools.md for the software commonly used in this role.
- See references/ai-skills.md โ matched external AI agent skills (per-source attribution).
Key competences (essential)
- actuarial science
- analyse claim files
- apply technical communication skills
- calculate compensation payments
- claims procedures
- classify insurance claims
- communicate with beneficiaries
- fraud detection
- handle incoming insurance claims
- insurance law
- interview insurance claimants
- maintain records of financial transactions
- manage claim files
- organise a damage assessment
- principles of insurance
Hot technologies
- Microsoft Access
- Microsoft Outlook
- Apple Safari
- Mozilla Firefox
- Microsoft Office software
- Microsoft PowerPoint
- Microsoft Excel
- Zoom
- Microsoft Word
Hot technologies
Top tools from 66 gated job ads (see references/market.md, as of 2026-07-14):
- Xactimate โ 21 %
- Microsoft Word โ 5 %
Sources: ESCO v1.2.1 (http://data.europa.eu/esco/occupation/01a83071-6533-4675-b2da-f0c6d02669f5), ONET 30.3 (13-1031.00). See manifest.json for licensing/attribution.*