Claims Adjusters, Examiners, and Investigators
Business and Financial Operations Occupations- O*NET-SOC コード
- 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.
- データ出典: BLS公表時点: 2026-08
非常に高い· 相対
低い4段階の相対区分非常に高い職業群単位の値
尺度・母数・出典
4段階の相対区分（低い / 中程度 / 高い / 非常に高い）
BLS雇用見通し表の詳細職業831件が母数。値は NEM(全国雇用マトリクス)コード単位で付与されるため、同じ NEM コードの職業は同じバンドになります
- データ出典: Anthropic公表時点: 2026-03
0.082
0.000ここに掲載された値の範囲0.745尺度・母数・出典
観測エクスポージャー指数、公開されたまま0–1
O*NETタスクへの対応づけが基準
SOC 2018の職業単位で公表された値で、同じSOC 2018コードを持つO*NET職業はすべてこの値になります
- データ出典: ILO公表時点: 2025
0.45
0.09ここに掲載された値の範囲0.70職業群単位の値
尺度・母数・出典
生成AI露出度指数、公開されたまま0–1
ISCO-08の細分類（4桁）単位で公表された値です。米国労働統計局（BLS）の公式対応表（ISCO-08→2010 SOC、2010 SOC→2018 SOC）を公表どおり適用してこの職業に結び付けており、対応は全部または一部です
この出典がどのような性格の値か
BLSの区分は絶対水準ではなく相対順位であり、一次測定でもありません。複数の既存研究が付けた職業別パーセンタイル順位を4段階にまとめた値です。雇用や賃金の予測でもなく、導入確率でもなく、自動化と増強を区別しません。
Task-level exposure
露出のある作業のみ評価済みタスク 29 件 · β ≥ 0.5 のタスク 28 件（96.6%）
β = 直接的な露出（E1）+ 0.5 × ツール利用時の露出（E2）。原典リポジトリの定義に従います。
- 原典の単位：O*NET 27.2 のタスク → O*NET 31.0 の職業コード
- 評価済みタスクはすべて O*NET 31.0 のタスク一覧にあります。
- 出典
- OpenAI "GPTs are GPTs" exposure rubric
- 版
- gh-main-0471612
- ライセンス
- MIT License, Copyright (c) 2024 OpenAI
O*NET-SOC 2010 の職業 13-1031.01 Claims Examiners, Property and Casualty Insurance; 13-1031.02 Insurance Adjusters, Examiners, and Investigators の作業です。当サイトが O*NET-SOC 2010→2019 公式クロスウォークによりこの職業に結び付けました
| Task (O*NET 20.1) | Claude.aiRaw / share % | APIRaw / share % |
|---|---|---|
Analyze information gathered by investigation and report findings and recommendations.13-1031.02 | 0.004821.0 | 0.00466.9 |
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.13-1031.01 | 0.003314.4 | 0.00253.7 |
Prepare reports to be submitted to company's data processing department.13-1031.01 | 0.002711.8 | 0.009313.9 |
Examine claims forms and other records to determine insurance coverage.13-1031.02 | 0.002410.5 | 0.029844.5 |
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.13-1031.01 | 0.00219.2 | 0.00436.4 |
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.13-1031.02 | 0.00219.2 | 0.00253.7 |
Examine titles to property to determine validity and act as company agent in transactions with property owners.13-1031.02 | 0.00208.7 | 0.00537.9 |
Obtain credit information from banks and other credit services.13-1031.02 | 0.00187.9 | 0.00203.0 |
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.13-1031.01 | 0.00177.4 | 0.00243.6 |
Investigate and assess damage to property and create or review property damage estimates. | —0 | 0.00263.9 |
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. | —0 | 0.00172.5 |
| Not observed on any surface — 18 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. | ||
Pay and process claims within designated authority level. | —0 | —0 |
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. | —0 | —0 |
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. | —0 | —0 |
Resolve complex, severe exposure claims, using high service oriented file handling. | —0 | —0 |
Present cases and participate in their discussion at claim committee meetings. | —0 | —0 |
Contact or interview claimants, doctors, medical specialists, or employers to get additional information. | —0 | —0 |
Confer with legal counsel on claims requiring litigation. | —0 | —0 |
Report overpayments, underpayments, and other irregularities. | —0 | —0 |
Communicate with reinsurance brokers to obtain information necessary for processing claims. | —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 |
Negotiate claim settlements and recommend litigation when settlement cannot be negotiated. | —0 | —0 |
Prepare report of findings of investigation. | —0 | —0 |
Collect evidence to support contested claims in court. | —0 | —0 |
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. | —0 | —0 |
Refer questionable claims to investigator or claims adjuster for investigation or settlement. | —0 | —0 |
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. | —0 | —0 |
Communicate with former associates to verify employment record and 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
O*NET 31.0 のタスク全件（29件）
この職業の O*NET 31.0 のタスク全件（英語原文、種別はコア・補足）。露出値はこの一覧には載せず、上の表で各出典が用いた O*NET 版の文言の横にあります。
| タスク（O*NET 31.0） | 種類 |
|---|---|
| Examine claims forms and other records to determine insurance coverage. | コア |
| Analyze information gathered by investigation and report findings and recommendations. | コア |
| Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. | コア |
| Investigate and assess damage to property and create or review property damage estimates. | コア |
| Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. | コア |
| Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. | コア |
| 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. | コア |
| Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. | コア |
| Resolve complex, severe exposure claims, using high service oriented file handling. | コア |
| Pay and process claims within designated authority level. | コア |
| Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments. | コア |
| 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. | コア |
| Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. | コア |
| Refer questionable claims to investigator or claims adjuster for investigation or settlement. | コア |
| Collect evidence to support contested claims in court. | コア |
| Confer with legal counsel on claims requiring litigation. | コア |
| Contact or interview claimants, doctors, medical specialists, or employers to get additional information. | コア |
| Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. | コア |
| Present cases and participate in their discussion at claim committee meetings. | コア |
| Report overpayments, underpayments, and other irregularities. | コア |
| Attend mediations or trials. | コア |
| Supervise claims adjusters to ensure that adjusters have followed proper methods. | 補足 |
| Conduct detailed bill reviews to implement sound litigation management and expense control. | 補足 |
| Examine titles to property to determine validity and act as company agent in transactions with property owners. | 補足 |
| Communicate with reinsurance brokers to obtain information necessary for processing claims. | 補足 |
| Prepare reports to be submitted to company's data processing department. | 補足 |
| Obtain credit information from banks and other credit services. | 補足 |
| 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· ロボット露出指数
尺度・母数・出典
身体的なタスクそれぞれに、実際に導入・販売・実演されたロボットがこなせる環境に応じて 0–3 の等級を付け（0 不可 · 1 フェンスで囲われた機械セルや瓶詰めラインのようなロボット専用設備 · 2 病院の薬剤部やコンテナ港のような管理された施設 · 3 一般家庭や建設現場のような非定型の環境）、勤務時間に占める割合で平均した値
この職業の O*NET 29.3 タスクのうち身体的なタスクが対象
等級と時間の割合は Anthropic が Claude Opus 5（ウェブ検索）で推定しました（2026年時点）。
ロボット露出指数は、このサイトの AI 露出度とは別の指標であり、足し合わせたり比べたりすることはできません。実際の導入やコスト競争力を示すものではなく、0 には身体的なタスクのない職業も含まれます。
身体的なタスクごとの等級
ロボット環境等級（E0–E3）
E0 ロボット不可詳細
実際に導入・販売・実演されたロボットでは、ロボット専用設備でもこなせないと評価
E1 ロボット専用設備詳細
フェンスで囲われた機械セルや瓶詰めラインのように、機械を中心に作られた設備でこなせると評価
E2 管理された施設詳細
病院の薬剤部やコンテナ港のように、機関が作業基準を保っている人の作業施設でこなせると評価
E3 非定型の環境詳細
一般家庭や建設現場のように、作業基準を保つ機関がない環境でこなせると評価
身体的なタスクに分類されたタスクのみを掲載しています。その他のタスクには出典で等級がないため載せていません。
| タスク（O*NET 29.3） | ロボット環境等級 |
|---|---|
| Investigate and assess damage to property and create or review property damage estimates. | E2 管理された施設 |
職業情報
雇用見通し（BLS）
- 雇用者数、2025
- 376K
- 雇用者数見通し、2035
- 356K
- 変化率 (2025–35)
- -5.5%
- 年間賃金の中央値、2025
- $78,000
- 入職時に通常必要な学歴
- High school diploma or equivalent
韓国職業分類との対応（KSCO）
AI Changing Work が作成した Korea Occupation Direct Crosswalk v1.1 現行版の対応です。関係の値は O*NET-SOC 職業の側から読みます。
| KSCO コード | KSCO 名称 | 関係 | 状態 |
|---|---|---|---|
| 28250 | 손해 사정사 | 範囲が同じ | 確定 |
| 34021 | 보험 심사원 | 重なるが同じではない | 確定 |
関係と状態の定義(kr-direct v1.1)
ILO（国際労働機関）の職業説明
以下のISCO-08職業群は、AI Changing Workが米国労働統計局（BLS）の発行するクロスウォーク（2018 SOC→2010 SOC、2010 SOC→ISCO-08）を個別の選択なしにそのまま適用して、この職業に結び付けたものです。結び付きは全体的な対応の場合も部分的な対応の場合もあります。
- ISCO-08 3315Valuers and Loss Assessors
価値・損害査定人
出典: 総務省「国際標準職業分類（ISCO）2008年改定版（仮訳）分類項目名一覧（和英対照）」— 原著：ILO ISCO-08 © International Labour Organization（日本語訳は総務省がILOの許可を得て作成）
以下の定義・作業・職業例は、この職業ではなく、当該ISCO-08職業群についてのILOによる説明です。
Valuers and loss assessors value property and various goods and assess losses covered by insurance policies.
作業
- (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.
職業例
Appraiser · Claims assessor · Claims inspector · Insurance assessor · Real estate appraiser · Valuer
Sources: ILO ISCO-08 — details: Credits
ESCO 職業語彙
以下の各項目は、公開されているESCO-O*NET Crosswalk（バージョン1、2022年）で、この職業と一つずつ対応付けられたものです。対応の種類はそのクロスウォークによるもので、表現はAI Changing Workによるものです。
- loss adjusterESCO 3315.5範囲が同じ
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 3315.3重なるが同じではない
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.
出典: European Commission, DG EMPL — ESCO API 2026-08-08 (bridge v1.2.1)
ライセンス: CC BY 4.0 (EU Reuse Notice)
ESCO reuse terms and the modification notice are in Credits.
フランス職業分類との対応（ROME）
この職業と ROME 4.0 の職業票（fiche）との対応で、AI Changing Work が AI モデルを用いて判定したものです。関係はこの職業の側から読みます。「暫定」と表示した対応は、同じモデル系列（Claude）の二人の判定者による判定のみ、またはその判定に運営者の規則を適用して採用したものであり、確定した対応より根拠が弱くなります。
| ROME コード | ROME 名称（フランス語） | 関係 |
|---|---|---|
| C1107 | Chargé / Chargée d'indemnisations en assurances | この職業のほうが広い暫定 |
| C1127 | Expert / Experte à distance sinistres et dommages en assurances | この職業のほうが広い暫定 |
| C1128 | Rédacteur / Rédactrice règlement assurances | この職業のほうが広い暫定 |
| C1125 | Responsable gestion des sinistres | 関連（対応ではない）暫定 |
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)
スペイン職業分類との対応（CNO-11）
この職業と CNO-11 の職業との対応で、AI Changing Work が AI モデルを用いて判定したものです。関係はこの職業の側から読みます。
| CNO-11 コード | CNO-11 名称（スペイン語） | 関係 |
|---|---|---|
| 3405 | Tasadores | この職業のほうが狭い暫定 |
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)
ドイツ職業分類との対応（KldB）
この職業と KldB の職業との対応で、AI Changing Work が AI モデルを用いて判定したものです。関係はこの職業の側から読みます。
| KldB コード | KldB 名称（ドイツ語） | 関係 |
|---|---|---|
| 72132 | Versicherungskaufleute - fachlich ausgerichtete Tätigkeiten | この職業のほうが狭い暫定 |
| 72133 | Versicherungskaufleute - komplexe Spezialistentätigkeiten | 関連（対応ではない）暫定 |
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)
日本職業分類との対応（JSCO）
この職業と JSCO の職業との対応で、AI Changing Work が AI モデルを用いて判定したものです。関係はこの職業の側から読みます。
| JSCO コード | JSCO 名称（日本語） | 関係 |
|---|---|---|
| 249 | 他に分類されない専門的職業従事者 | この職業のほうが狭い暫定 |
| 289 | その他の営業・販売事務従事者 | 関連（対応ではない） |
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)
このページのデータの出典・ライセンスと AI Changing Work による改変・翻訳の告知：クレジットと出典