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OaSIS 2025 Version 1.0
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12201.02 – Insurance claims examiners

Insurance claims examiners examine claims investigated by insurance adjusters and authorize payments.

Overview

Example job titles

  • Claims examiner

Core competencies

  • Evaluation and Systems Analysis to ensure claims are assessed accurately by carefully reviewing all relevant information, documents and evidence to determine validity
  • Critical Thinking and Decision Making to calculate claims and to examine adjusters' reports, similar claims and precedents in order to determine extent of insurance coverage
  • Information Ordering to systematically organize and evaluate the information gathered by insurance adjusters, ensuring all necessary details are considered for accurate claim assessments
  • Inductive Reasoning to identify patterns and trends in claims data so they can make predictions about the likely validity or complexity of current claims
  • Attention to Detail to carefully ensure claims are valid and settled according to company practices and procedures
  • Knowledge in Accounting to understand accounting principle to calculate claim amounts, including assessing damages, coverage limits and deductibles

Main duties

This group performs some or all of the following duties:

  • Review, examine, calculate and authorize insurance claims investigated by insurance adjusters
  • Examine adjusters' reports and similar insurance claims or precedents to determine extent of insurance coverage
  • Ensure claims are valid and settlements are made according to company practices and procedures
  • Consult lawyers, doctors or other relevant individuals to discuss insurance claims
  • Approve automobile, fire, life, disability, dental or other insurance claims.

Additional information

No data has been provided for this section.

Similar occupations classified elsewhere

No data has been provided for this section.

NOC hierarchy breakdown

NOC version

NOC 2021 Version 1.0

Broad occupational category

1 – Business, finance and administration occupations

TEER

2 – Occupations usually require a college diploma or apprenticeship training of two or more years; or supervisory occupations

Major group

12 – Administrative and financial supervisors and specialized administrative occupations

Sub-major group

122 – Accounting, insurance and related business administrative occupations

Minor group

1220 – Accounting, insurance and related business administrative occupations

Unit group

12201 – Insurance adjusters and claims examiners

Occupational profile

12201.02 – Insurance claims examiners

O*NET in-it

This page includes information from the O*NET 27.2 Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA). Used under the CC BY 4.0 license. O*NET® is a trademark of USDOL/ETA. Employment and Social Development Canada has modified all or some of this information. USDOL/ETA has not approved, endorsed, or tested these modifications.