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

    来源数据集（XLSX 文件下载）

  • 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

    观测暴露度指数，按发布原值0–1

    以O*NET任务映射为基准

    按 SOC 2018 职业发布的数值；具有相同 SOC 2018 代码的所有 O*NET 职业均显示此值

    来源数据集（CSV 文件下载）

  • 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

    来源数据集（PDF 文件下载）

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 18 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 %APIRaw / share %
Analyze information gathered by investigation and report findings and recommendations.

13-1031.02

0.004821.00.00466.9
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

0.003314.40.00253.7
Prepare reports to be submitted to company's data processing department.

13-1031.01

0.002711.80.009313.9
Examine claims forms and other records to determine insurance coverage.

13-1031.02

0.002410.50.029844.5
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

0.00219.20.00436.4
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.

13-1031.02

0.00219.20.00253.7
Examine titles to property to determine validity and act as company agent in transactions with property owners.

13-1031.02

0.00208.70.00537.9
Obtain credit information from banks and other credit services.

13-1031.02

0.00187.90.00203.0
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

13-1031.01

0.00177.40.00243.6
Investigate and assess damage to property and create or review property damage estimates.
—00.00263.9
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
—00.00172.5

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.—

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
最低 $30,890BLS EP 2025–35 中 825 个细分职业的工资中位数范围最高 $559,030

来源: U.S. Bureau of Labor Statistics, Employment Projections 2025–35 — Employment by detailed occupation, 2025 and projected 2035

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
28250손해 사정사范围相同已确认
34021보험 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)

查看原文

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
C1107Chargé / Chargée d'indemnisations en assurances本职业范围更宽暂定
C1127Expert / Experte à distance sinistres et dommages en assurances本职业范围更宽暂定
C1128Rédacteur / Rédactrice règlement assurances本职业范围更宽暂定
C1125Responsable 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
3405Tasadores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
72132Versicherungskaufleute - fachlich ausgerichtete Tätigkeiten本职业范围更窄暂定
72133Versicherungskaufleute - 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