Pros and Cons of an Insurance Claims Specialist Career
Your days as an insurance claims specialist will be filled with variety as you evaluate, appraise and investigate requests for insurance payouts. Below are listed several pros and cons to help you decided if this is the career for you.
| Pros of an Insurance Claims Specialist Career |
|---|
| Variety in daily activities (adjusting, examining, appraising or investigating claims)* |
| Only high school education required for some jobs* |
| Many difference industries offer career options (medical, automobile, home or business insurance)* |
| Pays well (median annual salary of roughly $62,000 in May 2014)* |
| Cons of an Insurance Claims Specialist Career |
|---|
| Low job growth expected in this field (only 4% growth predicted from 2012-2022)* |
| Often work irregular hours* |
| Might require license and continuing education* |
| Might require travel* |
Sources: *U.S. Bureau of Labor Statistics.
Essential Career Information
Job Description and Duties
An insurance claims specialist can work as an adjuster, examiner, appraiser or investigator, and often the job involves a combination of these duties. These individuals gather information to decide if the insurance company is obligated to pay a claim and, if so, how much. Claims specialists must be experts in their fields. For instance, a specialist who works for a health insurance company should know what the standard medical treatment for a condition is and how much this treatment usually costs.
Adjusters determine what the insurance company should pay and handle the settlement once the examiner approves the claim. For example, for auto or homeowners insurance claims, they inspect the damaged vehicle or building, look at police reports and take statements from the claimant and witnesses. Appraisers determine what the cost of repairs should be. They pass their estimates to adjusters for inclusion in the final settlement proposal.
Examiners review claims after submission to ensure that the insurance company and the claimant have followed proper procedures and that the claim is valid. Investigators look into claims the insurance company suspects might be fraudulent. Their work can include surveillance or examining medical records.
Most insurance claims specialists work for insurance companies. However, adjusters may be self-employed. Claimants sometimes hire these public adjusters as their representatives in negotiating with the insurance company. Insurance companies might contract with an adjuster for work, also. Most claims specialists work in an office, but adjusters and appraisers often travel to look at damaged vehicles and buildings. Adjusters, appraisers and investigators might work irregular hours and on weekends.
Career Outlook
The U.S. Bureau of Labor Statistics (BLS) predicted that jobs for insurance claims adjusters, examiners and investigators would grow by only 4% from 2012-2022, slower than average for all occupations. Most of the growth, the BLS said, would be in the health insurance industry. The BLS also noted that job growth in the field of property insurance often depends on the number of natural disasters, such as wildfires or hurricanes. If these events increase, insurance companies will need more claims adjusters. The BLS forecast the employment of vehicle damage appraisers would drop by 5% from 2012-2022, due to safer vehicles and fewer accidents.
Salary Info
The median annual salary for insurance adjusters, examiners and investigators was about $62,000 in May 2014, the BLS reported, with the middle half making between $47,000 and $77,000. The top ten percent made more than about $92,000, while the bottom ten percent made less than about $38,000, the BLS reported.
Career Skills and Requirements
Education and Training
While you can get a job with a high school diploma or a GED certificate, most employers prefer someone with a bachelor's degree or at least some college coursework. Vehicle damage appraisers usually have training in auto repair or experience working in a repair shop. Investigators generally have high school diplomas and interviewing experience as law enforcement officers or private investigators.
There's no standard college major for people who want to become insurance claims specialists, but majoring in insurance and risk management would be a sound choice. You'll study the basic types of insurance and take appropriate elective courses. If you don't major in insurance, choose courses that will prepare you for the field in which you want to work. People who work with industrial insurance will need knowledge of engineering and architecture, while training in health care would be useful to someone who wants to work with medical insurance.
Once they're hired, claims specialists undergo a few months of on-the-job training, supervised by more experienced personnel. They begin with close supervision on small claims and gradually increase their skills until they can work on their own.
Licensing Requirements
Licensing requirements vary between states. Some have few standards, while other states required you meet prescribed education standards and pass a licensing test. You might also have to complete continuing education courses to maintain your license and keep up with changing regulations in the insurance industry.
Useful Skills
Insurance claims specialists need to have excellent verbal and written communications skills. It helps to be sensitive to various situations and be able to recognize when something is wrong or when there is a problem with a claim. You'll need to be a good listener and have sound customer service ability.
What Real Employers Want
Job postings for insurance claims specialists show that most employers want someone with a bachelor's degree and experience in the insurance field. Proficiency in basic computer software, such as Microsoft Word, is noted as a requirement in most postings. Here's a sampling of job postings from real employers in April 2012:
- A staffing firm in New York was seeking to hire a claims specialist on a contract basis to handle construction labor law-related claims. The individual needed experience in bodily injury claims. The posting also mentioned good proofreading skills as a requirement.
- A California staffing company in the insurance field needed an experienced claims adjuster/examiner to look into Workers' Compensation claims. The posting said the individual should be able to manage reserve amounts on high-cost claims. Someone with the Experienced Adjuster designation was desired.
- In Oregon, an insurance company was looking for a hard worker with good customer service skills to become a claims adjuster trainee. In lieu of a degree, the company would accept a candidate with military or restaurant management experience.
- An insurance company in New York was looking for someone with at least five years experience to become a senior claims manager, investigating and adjusting complex auto and property claims. The posting made it clear that overtime might be required at no additional compensation.
How to Stand Out in the Field
Earn Professional Designations
Earning professional designations can help you expand your knowledge and demonstrate your ability to potential employers. The American Institute for Chartered Property Casualty Underwriters (AICPCU) offers a number of designations, including Associate in Claims. You'll choose a track, such as Workers' Compensation or property, and take courses to help you learn to reduce costs and improve customer satisfaction. The AICPCU says 70% of the people who earned a designation reported receiving a promotion within two years. Public adjusters can earn the Certified Professional Public Adjuster (CPPA) and Senior Professional Public Adjuster (SPPA) designations from the National Association of Public Insurance Adjusters (NAPIA).
Join an Association
Joining a professional association such as the International Claim Association (ICA), NAPIA or Chartered Property Casualty Underwriters (CPCU) might also help you make a mark in this field. You'll have access to continuing education courses and can attend seminars and conferences where you can network with other members.
Other Career Paths
Real Estate Appraiser or Assessor
A career with similar education requirements and salary, but without the requirement that you interview claimants, is as a real estate assessor or appraiser. An appraiser establishes a monetary value on property for sale or insurance, while an assessor works for the government to set a value for tax purposes. You can get a job in either field with a high school diploma, but the BLS said most appraisers have bachelor's degrees. Most states require that appraisers be certified, and some states require certification for assessors. The median annual salary for assessors and appraisers was nearly $49,000 in May 2011, the BLS reported.
Fire Inspector
Like an insurance claims specialist, a fire inspector goes out into the field to see the situation in person. You might visit places where a fire has occurred to help establish a cause or inspect buildings to ensure that fire safety codes are being followed and no hazards are present. You will need a high school diploma and experience working in a police or fire department to become a fire inspector. The median annual salary for a fire inspector was about $53,000 in May 2011, the BLS said.
