Claims Adjusters, Examiners, and Investigators
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Overview
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
Highlights
Undergraduate program resulting in the highest median salary ($70K): Economics
Largest undergraduate program (13.8% of workers): Business Management and Administration
Explore Pathways
Titles for this career often contain these words
ClaimsAdjusterExaminerClaimInsuranceSpecialistInvestigatorInspectorAnalystCompensationPropertyRepresentativeAuditorAdjustorDisabilityLiabilityMedicalWorkersServiceFieldFireHealthHomeOfficeLitigationReinsuranceAccidentAdjustmentClerkBenefitAuthorizerAgentApproverProcessorAccountConsultantClericalCommercialCorporateCustomerCareEstimatorGeneralistGeneralIndependentAppraiserFraudCasualtyDamageResidentialSalvageDeterminerWorker's
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Responsibilities and activities

Claims adjusters, appraisers, examiners, and investigators typically do the following:

  • Investigate, evaluate, and settle insurance claims
  • Determine whether the insurance policy covers the loss claimed
  • Decide the appropriate amount the insurance company should pay
  • Ensure that claims are not fraudulent
  • Contact claimants’ doctors or employers to get additional information on questionable claims
  • Talk with legal counsel about claims when needed
  • Negotiate settlements
  • Authorize payments

Claims adjusters, appraisers, examiners, and investigators have varying duties, depending on the type of insurance company they work for. They must know a lot about what their company insures. For example, workers in property and casualty insurance must know housing and construction costs so that they can properly evaluate damage from floods or fires. Workers in health insurance must be able to determine which types of treatments are medically necessary and which are questionable.

Adjusters inspect property damage or personal injury claims to determine how much the insurance company should pay for the loss. They might inspect a home, a business, or an automobile.

Adjusters interview the claimant and witnesses, inspect the property, and do additional research, such as look at police reports. They may consult with other workers, such as accountants, architects, construction workers, engineers, lawyers, and physicians, who can offer a more expert evaluation of a claim.

Adjusters gather information—including photographs and statements, either written or recorded on audio or video—and put together a report for claims examiners to review. When the examiner approves the claim, the adjuster negotiates with the policyholder and settles the claim.

If the claimant contests the outcome of the claim or the settlement, adjusters work with attorneys and expert witnesses to defend the insurer’s position.

Some claims adjusters work as public adjusters. Often, they are hired by claimants who prefer not to rely on the insurance company’s adjuster. The goal of adjusters working for insurance companies is to save as much money for the company as possible. The goal of a public adjuster working for a claimant is to get the highest possible amount paid to the claimant. They are paid a percentage of the settled claim.

Appraisers estimate the cost or value of an insured item. Most appraisers who work for insurance companies and independent adjusting firms are auto damage appraisers. They inspect damaged vehicles after an accident and estimate the cost of repairs. This information then goes to the adjuster, who puts the estimated cost of repairs into the settlement.

Claims examiners review claims after they are submitted to make sure claimants and adjusters followed proper guidelines. They may help adjusters with complicated claims or when, for example, a natural disaster occurs and the volume of claims increases.

Examiners who work for health insurance companies review health-related claims to see whether the costs are reasonable, given the diagnosis. After they review the claim, they authorize appropriate payment, deny the claim, or refer the claim to an investigator.

Examiners who work for life insurance companies review the causes of death and pay particular attention to accidents, because most life insurance companies pay additional benefits if a death is accidental. Examiners also may review new applications for life insurance policies to make sure that the applicants have no serious illnesses that would make them a high risk to insure.

Insurance investigators handle claims in which the company suspects fraudulent or criminal activity such as arson, staged accidents, or unnecessary medical treatments. The severity of insurance fraud cases varies, from overstated claims of vehicle damage to complicated fraud rings. Investigators often do surveillance work. For example, in the case of a fraudulent workers’ compensation claim, an investigator may covertly watch the claimant to see if he or she does anything that would be suspicious based on injuries stated in the claim.

Salary
Median salary: $68,270 annually
Half of those employed in this career earn between $52,160 and $85,820.
$68K$0$20K$40K$60K$80K$100K$120K
Context: Median Salary
How do salaries for this career compare to other jobs' salaries?
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Salary growth for claims adjusters, examiners, and investigators
Is this job likely to reward you for sticking with it through pay raises and promotions? The higher a job’s “experience quotient,” the more you are likely to get as you stay there.
Experience quotient percentile
Take a minute to look at how much you might expect your salary to increase with each five years' experience, as well as how the numbers working at each age change. Does this seem to be a job for the young or the old, or could it be a career offering steady salary growth for many years?
Salary distribution
$63K$61K$43K$54K$59K$62K$57K$49K$36K$0$20K$40K$60K$80K$100K$120K20-2425-2930-3435-3940-4445-4950-5455-5960-64
Number employed
010K20K30K40K50K20-2425-2930-3435-3940-4445-4950-5455-5960-64
About Claims Adjusters, Examiners, and Investigators
How do benefits for this career compare to other jobs? The availability of health care, especially employer provided health care, and pension plans can add significantly to the value of compensation you receive in a career. These charts compare how this career compares to other careers with regard to health care and pension plans.
Employee has health insurance
Employer is providing health insurance
Employer-provided pension plan is available
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Personality and skills
Can you see yourself in the ranks of Claims Adjusters, Examiners, and Investigators? Here are the skills and traits that could lead to success.
Analytical skills
Adjusters and examiners must each evaluate whether the insurance company is obligated to pay a claim and determine the amount to pay. Adjusters must consider various pieces of information to reach a decision.
Communication skills
Claims adjusters and investigators must get information from a range of people, including claimants, witnesses, and medical experts. They must know the right questions to ask in order to gather the information they need.
Detail oriented
Adjusters, appraisers, examiners, and investigators must carefully review documents and damaged property, because small details can have large financial consequences.
Interpersonal skills
Adjusters, examiners, and investigators often meet with claimants and others who may be upset by the situation that requires a claim or by the settlement the company is offering. These workers must be understanding, yet firm regarding their company’s policies.
Injury and Illness
About 14 claims adjusters, examiners, and investigators become injured or ill for every 10,000 workers, which reflects fewer events than in 50% of other careers. The most common specific illnesses or injuries are detailed following.
Carpal tunnel syndrome
All cuts, lacerations, punctures
Soreness and pain
Education pathways to this career
Education attained by claims adjusters, examiners, and investigators
According to the Bureau of Labor Statistics (BLS), claims adjusters, examiners, and investigators typically hold a high school diploma or equivalent.
Sometimes the typical education identified by the BLS differs a bit from the reality of the how much education current workers actually have. The donut shows the education level held by people currently working as claims adjusters, examiners, and investigators as reported in responses to the American Community Survey.
Details: Education and training recommended for claims adjusters, examiners, and investigators

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster or examiner. However, employers sometimes prefer to hire applicants who have a bachelor’s degree or some insurance-related work experience.

For investigator jobs, a high school diploma or equivalent is the typical education requirement. Some insurance companies prefer to hire people trained as law enforcement officers or private investigators, because these workers have good interviewing and interrogation skills.

Auto damage appraisers typically have either a postsecondary nondegree award or experience working in an auto repair shop, identifying and estimating the cost of automotive repair. Many vocational schools and some community colleges offer programs in autobody repair that teach students how to estimate the cost of repairing damaged vehicles.

Details: Licensing and certification recommended for claims adjusters, examiners, and investigators

Licensing requirements for claims adjusters, appraisers, examiners, and investigators vary by state. Some states have few requirements; others require either completing prelicensing education or receiving a satisfactory score on a licensing exam (or both). Jobseekers should verify the licensing laws with the state and locality in which they want to work. 

In some states, claims adjusters employed by insurance companies do not have to become licensed themselves because they can work under the company license.

Public adjusters may need to meet separate or additional requirements.

Some states that require licensing also require a certain number of continuing education credits per year to renew the license. Federal and state laws and the outcomes of claim disputes adjudicated in court affect how the claims must be handled and what insurance policies can and must cover. Examiners working on life and health claims must stay up to date on new medical procedures and prescription drugs. Examiners working on auto claims must be familiar with the most recent car models and repair techniques. To fulfill their continuing education requirements, workers can attend classes or workshops, write articles for claims publications, or give lectures and presentations.

The National Insurance Producer Registry (NIPR) provides information about state licensing requirements.

Education level of Claims Adjusters, Examiners, and Investigators
Only 49% of claims adjusters, examiners, and investigators have a bachelor's degree or higher.
Education attained by claims adjusters, examiners, and investigators
None
High School
Some College
Associate's Degree
Bachelor's Degree
Master's Degree
Professional Degree
Doctorate
Top college degrees
Here are the top college degrees held by the 48% of people in this job who have at least a bachelor's degree. Some of degrees may link to multiple programs due to the way Census classifies college majors. Click on a program to learn more about career opportunities for people who major in that field.
  1. Business Management and Administration
  2. Business/Commerce
  3. Psychology
  4. Criminal Justice and Fire Protection
  5. Finance
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College majors held by claims adjusters, examiners, and investigators
This table shows the college majors held by people working as claims adjusters, examiners, and investigators. If you see "**" before the name of a degree/program, that means this field is one that the Department of Education believes is preparatory for this career. However, you can see from this list that those recommendations are far from your only path to this job!
Salary comparison for bachelor's only
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Career salary (tail) versus Career/Major salary (dot)
Does the bachelor's-only salary rise or fall with this major?
$42K$70K
Salary for bachelor's-only
For people with this career and major
Median
Middle 50%
Middle 80%
Salary for all workers
For people with this career and major
Median
Middle 50%
Middle 80%
Education for Career and Major
Bachelor's
Master's
Professional
Doctorate
Workers with this career/major
Percentage in this career with this major
Programs recommended by the Department of Education
The Department of Education recommends the following college degree programs as preparation for this career. You can click a program row to learn more about the program and explore a list of schools that offer the program.
Number of degrees awarded in 2018
Education
Education level of awarded degrees
Assoc./Cert.
Bachelor's
Graduate
Gender
Gender of graduates
Men
Women
Race/Origin
Race/origin of graduates
White
Minority
International
Not so much?
The link between degrees and this career
With the following sankey diagram, you can follow the top ten bachelor's degrees held by people working as claims adjusters, examiners, and investigators, and then, in turn, you can see the 10 occupations that hire the most of each degree's graduates. We hope this provides ideas for similar jobs and similar fields of study.
Expand degrees
Business Management ...General BusinessPsychologyCriminal Justice and...FinancePolitical Science an...MarketingCommunicationsAccountingSociologyAll other degreesThis jobTop 10 majors
Where are the jobs
State-by-state employment numbers
Some careers tend to be centered in specific parts of the country. For example, most jobs in fashion are in New York or California. Let's see if your dream job is easy to find in your dream location! We have a few choices for viewing the data that can help you get a full employment picture.
Select a state to see local area details
Number of Claims Adjusters, Examiners, and Investigators per 1,000 workers (ACS)
AKMEWIVTNHWAIDMTNDMNILMINYMAORUTWYSDIAINOHPANJCTRICANVCONEMOKYWVVAMDDEAZNMKSARTNNCSCDCOKLAMSALGAHITXFLPR
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Job density versus job count
Which states hire the most claims adjusters, examiners, and investigators? We wonder if that's a fair question since states come in all sizes, so instead let's start with the question of which states have the highest density of people working as claims adjusters, examiners, and investigators. You can choose to view the number of jobs per state if you prefer.
Salaries by state
Let's get a feel for where claims adjusters, examiners, and investigators earn the highest salaries. There are several choices for which data we consider and how we view that data, and each can lead to different conclusions, so please read on...
Median salary versus state ratio
We use two methods to compare salaries across states:
  • In-state comparisons: the ratio of median (middle) salaries for claims adjusters, examiners, and investigators compared to the median salary for all people working in each state, or
  • Median salary: the unaltered median salaries for claims adjusters, examiners, and investigators.
We hope the ratio allows perspective about how salaries may compare to the regional cost-of-living.
The darkest shading corresponds to states in which claims adjusters, examiners, and investigators earn the highest salary when compared to other jobs in the state. We think this figure might be a better indicator than the actual salary for your buying power as a state resident.
Select a state to see local area details
Location-adjusted median salary for Claims Adjusters, Examiners, and Investigators (ACS for all specialties)
AKMEWIVTNHWAIDMTNDMNILMINYMAORUTWYSDIAINOHPANJCTRICANVCONEMOKYWVVAMDDEAZNMKSARTNNCSCDCOKLAMSALGAHITXFLPR
Employment
4% of Claims adjusters, examiners, and investigators are working part time.
We’ve found that some jobs have a huge number of part-time workers, and typically that is because they are unable to find full-time work or the job itself can’t provide full-time hours. With 4% part-time workers, this occupation has a lower percentage of part-time workers than 83% of careers.
4%0%20%40%60%80%100%
Employer types
This donut shares the break-down of workers by employer type, giving us a picture of what employers most typically hire for this career.
Employers of undefined (ACS)
Private for-profit
Private not-for-profit
Local government
State government
Federal government
Self-employed incorporated
Self-employed not incorporated
Working without pay
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Distribution: Salaries of claims adjusters, examiners, and investigators by type of employer
Here are the salary distributions based on employer type.
$54K$53K$55K$65K$52K$65K$50K$50K$0$50,000$100,000$150,000Self-employed not incorporatedSelf-employed incorporatedFederal governmentState governmentLocal governmentPrivate not-for-profitPrivate for-profitAll
Gender
Claims adjusters, examiners, and investigators and gender
With 59% women, this occupation has a higher percentage of women than 72% of careers.
Gender of Claims adjusters, examiners, and investigators
Men (41%)
Women (59%)
Distribution: salaries by gender
Does gender greatly influence your salary in this career? The closer the bars are, the less discrepancy there is.
$50K$61K$0$100K$200K$300KWomenMen
We only include salary data when the survey error is less than 20%, so you may see only partial information for some categories.
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Context: Women in the workforce
How does this career compare to other careers with regard to the percentage of women in the career.
59%0%20%40%60%80%100%
Context: Salary inequity
The median (middle) salary for all full-time male workers in the US exceeds the full-time median salary for women by 19%, and the difference for claims adjusters, examiners, and investigators tops that, with the median salary for men 22% higher than the median salary for women.
22%0%20%40%60%80%100%
Race/Origin
Race and origin of Claims adjusters, examiners, and investigators
This donut shows the distribution of race and origin among those employed as Claims adjusters, examiners, and investigators.
Race/origin of claims adjusters, examiners, and investigators
White (72% )
Black (17% )
Asian (4% )
Multiracial (2% )
Other (2% )
Hispanic (1% )
American Indian (0% )
Pacific Islander (0% )
Distribution: salaries by race/origin
Some careers might have a pay disparity based on race or origin, the closer the below bars are the less of a discrepancy is present.
$46K$48K$49K$50K$52K$55K$59K$0$20K$40K$60K$80K$100KAmerican IndianBlackOtherMultiracialHispanicWhiteAsian
We only include salary data when the survey error is less than 20%, so you may see only partial information for some categories.