Claims Adjusters, Examiners, and Investigators
Business and Financial Operations Occupations- O*NET-SOC code
- 13-1031.00
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.
- Data source: BLSPublished: 2026-08
Very high· relative
LowFour relative bandsVery highGroup-level value
Scale, basis and source
Four relative bands (Low / Moderate / High / Very high)
831 detailed occupations in the BLS Employment Projections table. Assigned per National Employment Matrix (NEM) code, so occupations sharing a NEM code carry the same band
- Data source: AnthropicPublished: 2026-03
0.082
0.000Range of values carried here0.745Scale, basis and source
Observed exposure index, 0–1 as published
Mapped onto O*NET tasks
Published per SOC 2018 occupation; every O*NET occupation with the same SOC 2018 code carries this value
- Data source: ILOPublished: 2025
0.45
0.09Range of values carried here0.70Group-level value
Scale, basis and source
Generative AI exposure index, 0–1 as published
Published per ISCO-08 unit group. Linked to this occupation, wholly or in part, by applying U.S. Bureau of Labor Statistics crosswalks (ISCO-08 to 2010 SOC, 2010 SOC to 2018 SOC) as published
What kind of figure this source publishes
The BLS category is a relative rank, not an absolute level, and it is not a first-hand measurement: it groups an occupation's percentile ranks across several published studies into four bands. It is not an employment or wage forecast, not a probability of adoption, and it does not separate automation from augmentation.
Task-level exposure
Exposed tasks only29 rated tasks · 28 tasks with β ≥ 0.5 (96.6%)
β = direct exposure (E1) + 0.5 × exposure when tools are available (E2), per the source repository's definition.
- Source unit: O*NET 27.2 tasks → O*NET 31.0 occupation code
- All rated tasks are in the O*NET 31.0 task list.
- Source
- OpenAI "GPTs are GPTs" exposure rubric
- Release
- gh-main-0471612
- License
- MIT License, Copyright (c) 2024 OpenAI
| Task (O*NET 30.2) | Claude.aiRaw / share % | APIRaw / share % |
|---|---|---|
Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.13-1031.00 | 0.0100100.0 | 0.00000.0 |
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. | —0 | 0.0100100.0 |
Analyze information gathered by investigation and report findings and recommendations. | —0 | 0.00000.0 |
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. | —0 | 0.00000.0 |
Report overpayments, underpayments, and other irregularities. | —0 | 0.00000.0 |
| Not observed on any surface — 24 task(s) — These tasks have no row in the source for this release. The 0 in the share row is a display-stage composition ratio; absence is what the — in the raw row states. | ||
Examine claims forms and other records to determine insurance coverage. | —0 | —0 |
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. | —0 | —0 |
Investigate and assess damage to property and create or review property damage estimates. | —0 | —0 |
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. | —0 | —0 |
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. | —0 | —0 |
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. | —0 | —0 |
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. | —0 | —0 |
Resolve complex, severe exposure claims, using high service oriented file handling. | —0 | —0 |
Pay and process claims within designated authority level. | —0 | —0 |
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments. | —0 | —0 |
Refer questionable claims to investigator or claims adjuster for investigation or settlement. | —0 | —0 |
Collect evidence to support contested claims in court. | —0 | —0 |
Confer with legal counsel on claims requiring litigation. | —0 | —0 |
Contact or interview claimants, doctors, medical specialists, or employers to get additional information. | —0 | —0 |
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. | —0 | —0 |
Present cases and participate in their discussion at claim committee meetings. | —0 | —0 |
Attend mediations or trials. | —0 | —0 |
Supervise claims adjusters to ensure that adjusters have followed proper methods. | —0 | —0 |
Conduct detailed bill reviews to implement sound litigation management and expense control. | —0 | —0 |
Examine titles to property to determine validity and act as company agent in transactions with property owners. | —0 | —0 |
Communicate with reinsurance brokers to obtain information necessary for processing claims. | —0 | —0 |
Prepare reports to be submitted to company's data processing department. | —0 | —0 |
Obtain credit information from banks and other credit services. | —0 | —0 |
Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit. | —0 | —0 |
Values in this tab are predicted labels, not observations. Eloundou et al. (2023) published two rating regimes — human raters and GPT-4 — and the β shown here is derived from the GPT-4 rater basis alone; the same task can take a different value under the other regime. The unit and the meaning differ from the observed shares (%) in the other tabs, so do not place them on the same axis.
| Task (O*NET 27.2) | βE1 + 0.5 × E2 |
|---|---|
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.O*NET Task ID 21429 | 1.0 |
Communicate with reinsurance brokers to obtain information necessary for processing claims.O*NET Task ID 21440 | 1.0 |
Prepare reports to be submitted to company's data processing department.O*NET Task ID 21441 | 1.0 |
Examine claims forms and other records to determine insurance coverage.O*NET Task ID 21417 | 0.5 |
Analyze information gathered by investigation and report findings and recommendations.O*NET Task ID 21418 | 0.5 |
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.O*NET Task ID 21419 | 0.5 |
Investigate and assess damage to property and create or review property damage estimates.O*NET Task ID 21420 | 0.5 |
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.O*NET Task ID 21421 | 0.5 |
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.O*NET Task ID 21422 | 0.5 |
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.O*NET Task ID 21423 | 0.5 |
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.O*NET Task ID 21424 | 0.5 |
Resolve complex, severe exposure claims, using high service oriented file handling.O*NET Task ID 21425 | 0.5 |
Pay and process claims within designated authority level.O*NET Task ID 21426 | 0.5 |
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.O*NET Task ID 21427 | 0.5 |
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.O*NET Task ID 21428 | 0.5 |
Refer questionable claims to investigator or claims adjuster for investigation or settlement.O*NET Task ID 21430 | 0.5 |
Collect evidence to support contested claims in court.O*NET Task ID 21431 | 0.5 |
Confer with legal counsel on claims requiring litigation.O*NET Task ID 21432 | 0.5 |
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.O*NET Task ID 21433 | 0.5 |
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.O*NET Task ID 21434 | 0.5 |
Present cases and participate in their discussion at claim committee meetings.O*NET Task ID 21435 | 0.5 |
Supervise claims adjusters to ensure that adjusters have followed proper methods.O*NET Task ID 21436 | 0.5 |
Conduct detailed bill reviews to implement sound litigation management and expense control.O*NET Task ID 21437 | 0.5 |
Examine titles to property to determine validity and act as company agent in transactions with property owners.O*NET Task ID 21438 | 0.5 |
Report overpayments, underpayments, and other irregularities.O*NET Task ID 21439 | 0.5 |
Obtain credit information from banks and other credit services.O*NET Task ID 21442 | 0.5 |
Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.O*NET Task ID 21444 | 0.5 |
Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.O*NET Task ID 21445 | 0.5 |
Attend mediations or trials.O*NET Task ID 21443 | 0.0 |
β = E1 + 0.5 × E2 · E1 = tasks where direct LLM access alone cuts time by at least 50%, E2 = tasks where software built on top of an LLM cuts time by at least 50%. Values take only 0 / 0.5 / 1.0.
Data sources & licenses — O*NET®, Anthropic Economic Index, Eloundou et al. (2023): see full notices on the Credits page
All O*NET 31.0 task statements (29)
All O*NET 31.0 task statements for this occupation (English, as published; task type core or supplemental). Exposure values are not listed here; they are in the table above, next to each task statement as worded in the O*NET version each source used.
| Task (O*NET 31.0) | Type |
|---|---|
| Examine claims forms and other records to determine insurance coverage. | Core |
| Analyze information gathered by investigation and report findings and recommendations. | Core |
| Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. | Core |
| Investigate and assess damage to property and create or review property damage estimates. | Core |
| Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. | Core |
| Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. | Core |
| 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. | Core |
| Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. | Core |
| Resolve complex, severe exposure claims, using high service oriented file handling. | Core |
| Pay and process claims within designated authority level. | Core |
| Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments. | Core |
| 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. | Core |
| Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. | Core |
| Refer questionable claims to investigator or claims adjuster for investigation or settlement. | Core |
| Collect evidence to support contested claims in court. | Core |
| Confer with legal counsel on claims requiring litigation. | Core |
| Contact or interview claimants, doctors, medical specialists, or employers to get additional information. | Core |
| Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. | Core |
| Present cases and participate in their discussion at claim committee meetings. | Core |
| Report overpayments, underpayments, and other irregularities. | Core |
| Attend mediations or trials. | Core |
| Supervise claims adjusters to ensure that adjusters have followed proper methods. | Supplemental |
| Conduct detailed bill reviews to implement sound litigation management and expense control. | Supplemental |
| Examine titles to property to determine validity and act as company agent in transactions with property owners. | Supplemental |
| Communicate with reinsurance brokers to obtain information necessary for processing claims. | Supplemental |
| Prepare reports to be submitted to company's data processing department. | Supplemental |
| Obtain credit information from banks and other credit services. | Supplemental |
| Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit. | — |
| Negotiate claim settlements or recommend litigation when settlement cannot be negotiated. | — |
0.10/ 3· Robot exposure index
Scale, basis and source
Each physical task is graded 0–3 by the setting in which robots that have been deployed, sold or demonstrated could do it (0 none · 1 purpose-built robot settings such as a fenced machine cell or a bottling line · 2 structured facilities such as a hospital pharmacy or a container port · 3 unstructured settings such as a private home or a construction site), and the grades are averaged by share of working time
Physical tasks among this occupation's O*NET 29.3 tasks
Anthropic estimated the grades and time shares with Claude Opus 5 using web search, as of 2026.
The robot exposure index is a different measure from the AI exposure figures on this site and cannot be added to or compared with them. It does not measure actual adoption or cost, and 0 also covers occupations with no physical tasks.
Tier of each physical task
Robot environment tiers (E0–E3)
E0 noneDetails
Rated not doable by robots that have been deployed, sold or demonstrated, even in a purpose-built setting
E1 purpose-built robot settingsDetails
Rated doable in a setting built around the machine, such as a fenced machine cell or a bottling line
E2 structured facilitiesDetails
Rated doable in a human work facility that an institution keeps to a working standard, such as a hospital pharmacy or a container port
E3 unstructured settingsDetails
Rated doable in a setting that no institution keeps to a working standard, such as a private home or a construction site
Only tasks classified as physical are listed; other tasks have no tier in the source.
| Task (O*NET 29.3) | Robot environment tier |
|---|---|
| Investigate and assess damage to property and create or review property damage estimates. | E2 structured facilities |
Occupation information
Employment outlook (BLS)
- Employment, 2025
- 376K
- Projected employment, 2035
- 356K
- Change (2025–35)
- -5.5%
- Median annual wage, 2025
- $78,000
- Typical education needed for entry
- High school diploma or equivalent
Korea classification links (KSCO)
Links from the current release of the Korea Occupation Direct Crosswalk v1.1, made by AI Changing Work. Relation values are read from the O*NET-SOC occupation side.
| KSCO code | KSCO title | Relation | Status |
|---|---|---|---|
| 28250 | 손해 사정사 | Same scope | confirmed |
| 34021 | 보험 심사원 | Overlapping, not the same | confirmed |
Relation and status definitions(kr-direct v1.1)
ILO occupational description
AI Changing Work links the ISCO-08 unit groups below to this occupation by applying the U.S. Bureau of Labor Statistics crosswalks (2018 SOC to 2010 SOC, 2010 SOC to ISCO-08) as published, without case-by-case selection; each link may be whole or partial.
- ISCO-08 3315Valuers and Loss Assessors
The definition, tasks and examples below are the ILO's description of that unit group, not of this occupation.
Valuers and loss assessors value property and various goods and assess losses covered by insurance policies.
Tasks
- (a) determining the quality or value of raw materials, real estate, industrial equipment, personal and household effects, works of art, gems and other objects;
- (b) assessing the extent of damage or loss and liabilities of insurance companies and underwriters for losses covered by insurance policies;
- (c) obtaining records of sales and value of similar items or property;
- (d) inspecting items or property to evaluate condition, size and construction;
- (e) preparing reports of value, outlining the estimation factors and methods used.
Example occupations
Appraiser · Claims assessor · Claims inspector · Insurance assessor · Real estate appraiser · Valuer
Sources: ILO ISCO-08 — details: Credits
ESCO occupational vocabulary
Each entry below is matched to this occupation in the published ESCO-O*NET Crosswalk (version 1, 2022). The match types are that crosswalk's; the wording is AI Changing Work's.
- loss adjusterESCO 3315.5Same scope
Loss adjusters treat and evaluate insurance claims by investigating the cases and determining liability and damage, in accordance with the policies of the insurance company. They interview the claimant and witnesses and write reports for the insurer where appropriate recommendations for the settlement are made. Loss adjusters' tasks include making payments to the insured following his claim, consulting damage experts and providing information via telephone to the clients.
- insurance claims handlerESCO 3315.3Overlapping, not the same
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.
Source: European Commission, DG EMPL — ESCO API 2026-08-08 (bridge v1.2.1)
License: CC BY 4.0 (EU Reuse Notice)
ESCO reuse terms and the modification notice are in Credits.
France classification links (ROME)
AI Changing Work's links between this occupation and ROME 4.0 job profiles, judged with AI models. Relations are read from this occupation's side. Links marked “provisional” were adopted on the judgments of two judges from the same model family (Claude) alone, or by an operator rule applied to their judgments, so they rest on weaker evidence than confirmed links.
| ROME code | ROME title (French) | Relation |
|---|---|---|
| C1107 | Chargé / Chargée d'indemnisations en assurances | This occupation is broaderprovisional |
| C1127 | Expert / Experte à distance sinistres et dommages en assurances | This occupation is broaderprovisional |
| C1128 | Rédacteur / Rédactrice règlement assurances | This occupation is broaderprovisional |
| C1125 | Responsable gestion des sinistres | Related, not a matchprovisional |
Source: France Travail — Répertoire Opérationnel des Métiers et des Emplois (ROME 4.0), version 61, last updated 15 June 2026 (https://www.data.gouv.fr/datasets/repertoire-operationnel-des-metiers-et-des-emplois-rome). Licence Ouverte 2.0.
ROME codes and titles are reproduced unchanged; the links to O*NET-SOC occupations are AI Changing Work's own judgment and are not a France Travail correspondence.
(AI Changing Work link release: fr-direct v1)
Spain classification links (CNO-11)
AI Changing Work's links between this occupation and CNO-11 occupations, judged with AI models. Relations are read from this occupation's side.
| CNO-11 code | CNO-11 title (Spanish) | Relation |
|---|---|---|
| 3405 | Tasadores | This occupation is narrowerprovisional |
Source: Instituto Nacional de Estadística (INE), National Classification of Occupations 2011 (CNO-11, Royal Decree 1591/2010) — www.ine.es · Licensed CC BY 4.0. CNO-11 codes and Spanish titles are reproduced unchanged; the links to O*NET occupations are AI Changing Work's own judgment and are not an INE correspondence.
(AI Changing Work link release: es-direct v1)
Germany classification links (KldB)
AI Changing Work's links between this occupation and KldB occupations, judged with AI models. Relations are read from this occupation's side.
| KldB code | KldB title (German) | Relation |
|---|---|---|
| 72132 | Versicherungskaufleute - fachlich ausgerichtete Tätigkeiten | This occupation is narrowerprovisional |
| 72133 | Versicherungskaufleute - komplexe Spezialistentätigkeiten | Related, not a matchprovisional |
Source: © Statistik der Bundesagentur für Arbeit — Klassifikation der Berufe 2010 – überarbeitete Fassung 2020, https://statistik.arbeitsagentur.de. KldB codes and titles are reproduced unchanged; the links to O*NET occupations are AI Changing Work's own mapping (eigene Zuordnung) and are not a Bundesagentur für Arbeit correspondence.
(AI Changing Work link release: de-direct v1)
Japan classification links (JSCO)
AI Changing Work's links between this occupation and JSCO occupations, judged with AI models. Relations are read from this occupation's side.
| JSCO code | JSCO title (Japanese) | Relation |
|---|---|---|
| 249 | 他に分類されない専門的職業従事者 | This occupation is narrowerprovisional |
| 289 | その他の営業・販売事務従事者 | Related, not a match |
Source: Ministry of Internal Affairs and Communications (MIC), Japan Standard Occupational Classification (Dec. 2009, MIC Notification No. 555). JSCO codes and Japanese titles are reproduced unchanged; the links to O*NET occupations are AI Changing Work's own judgment and are not a MIC correspondence.
(AI Changing Work link release: jp-direct v1)
Sources, licenses and AI Changing Work's modification and translation notices for this page: Credits & sources