Insurance claims representatives work for insurance companies. They investigate claims by customers who have suffered personal injury or damage to vehicles and property covered by their insurance policies. Claims representatives evaluate the damage and calculate the amount of compensation due to customers. They also ensure that claims are genuine and do not involve any fraudulent actions.
A high school diploma is the minimum requirement for this position, although, according to the U.S. Bureau of Labor Statistics, some employers prefer to recruit representatives with a bachelor’s degree. BLS also notes that licensing requirements for this job vary from state to state. The American Institute for Chartered Property Casualty Underwriters, also known as The Institutes, offers a professional qualification, Associate in Claims, to representatives who complete a course and pass an examination.
Claims representatives must have a good technical understanding of the type of property they are investigating, so that they can assess the extent of the damage and the cost of repair. Experience in industries such as construction or automotive is therefore important for representatives handling claims in those areas. Representatives investigating a claim for collision damage, for example, must decide if a vehicle can be economically repaired to a safe, roadworthy condition. If not, the insurance company must treat the vehicle as a total loss and offer the customer its estimated pre-accident value.
Analytical skills are important for this role. Insurance claims representatives must assess the circumstances of a claim to ensure that it is legitimate and that the company is liable for paying compensation. If a customer claims loss of property following a burglary, for example, the investigator checks the security at the property. If a customer has failed to fit a burglar alarm or door lock specified in the policy, the representative may refuse to settle the claim.
Insurance claims representatives must have good interpersonal skills. They deal with customers who may be under stress following an accident or damage to their property. They require good negotiating skills to make settlement offers that represent fair value to the customer, but protect the financial interests of the insurance company. Claims representatives must also deal discretely and professionally with other people, such as police, doctors, eyewitnesses or neighbors, when they are investigating claims.