Claims Adjusters, Examiners, and Investigators
Business and Financial Operations Occupations- O*NET-SOC 代码
- 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.
- 数据来源: BLS发布时间: 2026-08
很高· 相对
低四级相对区间很高职业群单位数值
尺度 · 母数 · 来源
四级相对类别（低 / 中等 / 高 / 很高）
以BLS就业预测表中831个细分职业为基数。取值按 NEM（全国就业矩阵）代码给定，因此共用同一 NEM 代码的职业得到相同分档
- 数据来源: Anthropic发布时间: 2026-03
0.082
0.000此处所载数值的范围0.745尺度 · 母数 · 来源
- 数据来源: ILO发布时间: 2025
0.45
0.09此处所载数值的范围0.70职业群单位数值
尺度 · 母数 · 来源
生成式AI暴露度指数，按发布原值0–1
按 ISCO-08 细类（4 位）发布的数值。按原样应用美国劳工统计局（BLS）的官方对照表（ISCO-08→2010 SOC、2010 SOC→2018 SOC）关联到本职业，对应关系为全部或部分对应
该来源发布的是什么性质的数值
BLS的类别是相对排位而非绝对水平，也不是一手测量：它把多项已发表研究给出的职业百分位排名归并为四个等级。它不是就业或工资预测，不是采用概率，也不区分自动化与增强。
Task-level exposure
显示隐藏的 26 项工作已评分任务 29 项 · β ≥ 0.5 的任务 28 项（96.6%）
β = 直接暴露（E1）+ 0.5 × 借助工具时的暴露（E2），依据原始代码库的定义。
- 原始单位：O*NET 27.2 任务 → O*NET 31.0 职业代码
- 所有已评分任务均在 O*NET 31.0 任务列表中。
- 来源
- OpenAI "GPTs are GPTs" exposure rubric
- 版本
- gh-main-0471612
- 许可
- MIT License, Copyright (c) 2024 OpenAI
以下为 O*NET-SOC 2010 职业 13-1031.01 Claims Examiners, Property and Casualty Insurance; 13-1031.02 Insurance Adjusters, Examiners, and Investigators 的工作任务，由本站依据 O*NET-SOC 2010→2019 官方对照表关联到此职业
| Task (O*NET 20.1) | Claude.aiRaw / share % |
|---|---|
Analyze information gathered by investigation and report findings and recommendations.13-1031.02 | 0.016366.1 |
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 | 0.004418.0 |
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.13-1031.01 | 0.003915.9 |
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 |
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 全部任务（29 项）
本职业在 O*NET 31.0 中的全部任务（英文原文；任务类型为核心或补充）。暴露值不列在此清单中，而在上方表格里，位于各来源所用 O*NET 版本的任务表述旁。
| 任务（O*NET 31.0） | 类型 |
|---|---|
| Examine claims forms and other records to determine insurance coverage. | 核心 |
| Analyze information gathered by investigation and report findings and recommendations. | 核心 |
| Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. | 核心 |
| Investigate and assess damage to property and create or review property damage estimates. | 核心 |
| Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. | 核心 |
| Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. | 核心 |
| 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. | 核心 |
| Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. | 核心 |
| Resolve complex, severe exposure claims, using high service oriented file handling. | 核心 |
| Pay and process claims within designated authority level. | 核心 |
| Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments. | 核心 |
| 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. | 核心 |
| Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. | 核心 |
| Refer questionable claims to investigator or claims adjuster for investigation or settlement. | 核心 |
| Collect evidence to support contested claims in court. | 核心 |
| Confer with legal counsel on claims requiring litigation. | 核心 |
| Contact or interview claimants, doctors, medical specialists, or employers to get additional information. | 核心 |
| Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. | 核心 |
| Present cases and participate in their discussion at claim committee meetings. | 核心 |
| Report overpayments, underpayments, and other irregularities. | 核心 |
| Attend mediations or trials. | 核心 |
| Supervise claims adjusters to ensure that adjusters have followed proper methods. | 补充 |
| Conduct detailed bill reviews to implement sound litigation management and expense control. | 补充 |
| Examine titles to property to determine validity and act as company agent in transactions with property owners. | 补充 |
| Communicate with reinsurance brokers to obtain information necessary for processing claims. | 补充 |
| Prepare reports to be submitted to company's data processing department. | 补充 |
| Obtain credit information from banks and other credit services. | 补充 |
| 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· 机器人暴露指数
尺度 · 母数 · 来源
对每项体力任务，按已实际部署、销售或演示的机器人能够完成它的环境评定 0–3 级（0 不可 · 1 围栏式机器单元、灌装线等机器人专用设施 · 2 医院药房、集装箱港口等受管理的设施 · 3 私人住宅、建筑工地等非结构化环境），再按工作时间占比求平均
以该职业 O*NET 29.3 任务中的体力任务为准
等级与时间占比由 Anthropic 使用 Claude Opus 5（网络搜索）估算（截至 2026 年）。
机器人暴露指数与本站的 AI 暴露度是不同的指标，不能相加或相互比较。该指数不代表实际采用情况或成本竞争力，0 也包括没有体力任务的职业。
每项体力任务的等级
机器人环境等级（E0–E3）
E0 机器人不可详情
评定为已实际部署、销售或演示的机器人即使在机器人专用设施中也无法完成
E1 机器人专用设施详情
评定为可在围绕机器搭建的设施中完成，例如围栏式机器单元或灌装线
E2 受管理的设施详情
评定为可在由机构按工作标准维护的人类工作设施中完成，例如医院药房或集装箱港口
E3 非结构化环境详情
评定为可在没有机构按工作标准维护的环境中完成，例如私人住宅或建筑工地
仅列出被归类为体力任务的任务；其他任务在来源中没有等级。
| 任务（O*NET 29.3） | 机器人环境等级 |
|---|---|
| Investigate and assess damage to property and create or review property damage estimates. | E2 受管理的设施 |
职业信息
就业展望（BLS）
- 就业人数，2025
- 376K
- 预计就业人数，2035
- 356K
- 变化 (2025–35)
- -5.5%
- 年薪中位数，2025
- $78,000
- 入职通常所需学历
- High school diploma or equivalent
韩国职业分类关联（KSCO）
来自 AI Changing Work 制作的 Korea Occupation Direct Crosswalk v1.1 当前版本的关联。关系值从 O*NET-SOC 职业一侧解读。
| KSCO 代码 | KSCO 名称 | 关系 | 状态 |
|---|---|---|---|
| 28250 | 손해 사정사 | 范围相同 | 已确认 |
| 34021 | 보험 심사원 | 有重叠，但不相同 | 已确认 |
关系与状态的定义(kr-direct v1.1)
国际劳工组织（ILO）职业说明
以下 ISCO-08 职业组由 AI Changing Work 原样套用美国劳工统计局（BLS）发布的对照表（2018 SOC→2010 SOC、2010 SOC→ISCO-08）、不逐案取舍，与本职业相关联；每项关联可能是完全对应，也可能是部分对应。
- ISCO-08 3315Valuers and Loss Assessors
评估师和理赔员
自行翻译
自行翻译 · 非 ISCO 官方词汇 — 未经国际劳工组织审核。
以下定义、任务和职业示例是 ILO 对该 ISCO-08 职业组的描述，而不是对本职业的描述。
Valuers and loss assessors value property and various goods and assess losses covered by insurance policies.
任务
- (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.
职业示例
Appraiser · Claims assessor · Claims inspector · Insurance assessor · Real estate appraiser · Valuer
Sources: ILO ISCO-08 — details: Credits
ESCO 职业词汇
以下每一项都是在已公开的ESCO-O*NET Crosswalk（第 1 版，2022 年）中与本职业逐项对应的。对应类型出自该对照表；表述出自 AI Changing Work。
- loss adjusterESCO 3315.5范围相同
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有重叠，但不相同
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.
来源: European Commission, DG EMPL — ESCO API 2026-08-08 (bridge v1.2.1)
许可: CC BY 4.0 (EU Reuse Notice)
ESCO reuse terms and the modification notice are in Credits.
法国职业分类关联（ROME）
本职业与 ROME 4.0 职业条目（fiche）之间的关联，由 AI Changing Work 借助 AI 模型判定。关系从本职业一侧解读。标为「暂定」的关联仅凭同一模型系列（Claude）两位判定者的判定采纳，或对其判定适用运营方规则后采纳，因此其依据弱于已确认的关联。
| ROME 代码 | ROME 名称（法语） | 关系 |
|---|---|---|
| C1107 | Chargé / Chargée d'indemnisations en assurances | 本职业范围更宽暂定 |
| C1127 | Expert / Experte à distance sinistres et dommages en assurances | 本职业范围更宽暂定 |
| C1128 | Rédacteur / Rédactrice règlement assurances | 本职业范围更宽暂定 |
| C1125 | Responsable gestion des sinistres | 相关，但不对应暂定 |
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)
西班牙职业分类关联（CNO-11）
本职业与 CNO-11 职业之间的关联，由 AI Changing Work 借助 AI 模型判定。关系从本职业一侧解读。
| CNO-11 代码 | CNO-11 名称（西班牙语） | 关系 |
|---|---|---|
| 3405 | Tasadores | 本职业范围更窄暂定 |
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)
德国职业分类关联（KldB）
本职业与 KldB 职业之间的关联，由 AI Changing Work 借助 AI 模型判定。关系从本职业一侧解读。
| KldB 代码 | KldB 名称（德语） | 关系 |
|---|---|---|
| 72132 | Versicherungskaufleute - fachlich ausgerichtete Tätigkeiten | 本职业范围更窄暂定 |
| 72133 | Versicherungskaufleute - komplexe Spezialistentätigkeiten | 相关，但不对应暂定 |
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)
日本职业分类关联（JSCO）
本职业与 JSCO 职业之间的关联，由 AI Changing Work 借助 AI 模型判定。关系从本职业一侧解读。
| JSCO 代码 | JSCO 名称（日语） | 关系 |
|---|---|---|
| 249 | 他に分類されない専門的職業従事者 | 本职业范围更窄暂定 |
| 289 | その他の営業・販売事務従事者 | 相关，但不对应 |
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)
本页数据的来源与许可，以及 AI Changing Work 的修改与翻译说明：致谢与来源