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Business & Finance · Updated Aug 2026

Claims Adjusters, Examiners, and Investigators

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.

JVS 2.0.0-phase4b
AI Exposure
68/100
High

How much of this occupation’s work can be materially affected by current AI systems.

Replacement Risk
60/100
High

How likely exposure is to translate into reduced human demand.

Includes provisional estimates for AI adoption pressure and labour-market resilience. How this is measured

Evidence quality
Confidence82/100
Task coverage86%

Confidence reflects task coverage, mapping and capability-evidence quality, and how much of the score rests on provisional inputs.

Task-level evidence

What is driving the score?

Occupation scores are built from the task mix—not a single prediction about a job title.

JVS 2.0.0-phase4b
TaskImportanceAI impactExposure
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.High
73
Analyze information gathered by investigation and report findings and recommendations.High
73
Investigate and assess damage to property and create or review property damage estimates.High
73
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.High
73
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.High
73
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.High
71
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.High
68
Examine claims forms and other records to determine insurance coverage.High
57
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.High
74
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.High
73
Supervise claims adjusters to ensure that adjusters have followed proper methods.High
72
Resolve complex, severe exposure claims, using high service oriented file handling.High
73
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.High
58
Refer questionable claims to investigator or claims adjuster for investigation or settlement.High
74
Prepare reports to be submitted to company's data processing department.Medium
74
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.High
59
Conduct detailed bill reviews to implement sound litigation management and expense control.High
73
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.High
39
Present cases and participate in their discussion at claim committee meetings.Medium
74
Report overpayments, underpayments, and other irregularities.Medium
74
Examine titles to property to determine validity and act as company agent in transactions with property owners.Medium
38
Most exposed

Where AI can do more

Routine, digitized, and highly repeatable tasks face the greatest pressure.

  1. Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.74
  2. Refer questionable claims to investigator or claims adjuster for investigation or settlement.74
  3. Prepare reports to be submitted to company's data processing department.74
  4. Present cases and participate in their discussion at claim committee meetings.74
Hardest to automate

Where people still matter

These tasks score lowest on automation feasibility—physical presence, judgement, accountability and real-world variability all resist end-to-end automation.

  1. Examine titles to property to determine validity and act as company agent in transactions with property owners.01
  2. Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.02
  3. 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.03
  4. Analyze information gathered by investigation and report findings and recommendations.04
  5. Investigate and assess damage to property and create or review property damage estimates.05
Where else this work leads

Related occupations

Occupations O*NET links to this one. Relatedness reflects shared work, not a claim that these roles are safer.

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Beyond AI capability

Adoption and labour-market outlook

Structural factors are kept separate from raw capability so you can see what actually resists automation. Adoption pressure and labour-market resilience are still provisional models—25% of this occupation’s replacement-risk weight rests on them.

Human dependency74
Physical dependency26
Adoption pressure71
Labour-market resilience57
Methodology & sources

O*NET 30.3 occupational data interpreted through the JobsVsAI capability, automation and structural-constraint models.

Confidence82/100
CalculatedAug 21, 2026
Read methodology →