What does an insurance examiner do?
A claims examiner is responsible for conducting a claim review of a client against a particular insurance company--usually a health and life insurance company. An examiner must review claims and then approve them, reject them, or develop a possible settlement. They need to communicate with policyholders and insurance agents to assess if all the information under the company's claims guidelines and policies are correct and accurate.
Insurance examiner responsibilities
Here are examples of responsibilities from real insurance examiner resumes:
- Manage operating procedure and accounting systems for payroll, operating expenses, supplies and inventory management and commercial accounts.
- Court / arbitration / litigation appearances.
- Review the subpoenas records in court house.
- Used audit software utilize at insure's site, with PAAS and GAAP.
- Draw blood from veins by vacuum tube, syringe, or butterfly venipuncture methods.
- Perform insurance exams in client's homes which including history and physicals and phlebotomy.
- Prepare detailed written reports for the legal department, SIU unit, and insurance company.
- Maintain a good working knowledge of generally accept accounting principles (GAAP) and financial statement analysis.
- Collect various samples such as blood, urine EKG, blood pressures as well as height and weight.
- Obtain, document, and preserve physical evidence to support inquiries as well as a hand in hand relationship with SIU.
- Serve subpoenas and settlement documents.
- Perform phlebotomy per insurance company requirements.
- Perform venipuncture blood draws in a fast-pace environment.
- Conduct ABL collateral audits on secure lending customers.
- Complete examinations of sub-prime automobile and consumer loan companies along with assisting in several ABL examinations.
Insurance examiner skills and personality traits
We calculated that 14% of Insurance Examiners are proficient in EKG, Financial Statements, and Blood Pressure. They’re also known for soft skills such as Communication skills, Interpersonal skills, and Math skills.
We break down the percentage of Insurance Examiners that have these skills listed on their resume here:
- EKG, 14%
Assessed the individual's vitals, EKG and collected specimens required by the life insurance company.
- Financial Statements, 7%
Produced report summarizing the financial conditions of insurance companies and auditing financial statements in compliance with Florida Statutes.
- Blood Pressure, 6%
Record detailed information from applicant including blood pressure, height, weight, pulse and family history.
- Health History, 6%
Performed health physical examinations, health history, and blood and urine lab testing on people seeking life insurance.
- Vital Signs, 6%
Gathered detailed medical histories including physical measurements and vital signs.
- Naic, 6%
Valued securities in accordance with NAIC instructions and the Florida Statute.
Common skills that an insurance examiner uses to do their job include "ekg," "financial statements," and "blood pressure." You can find details on the most important insurance examiner responsibilities below.
Communication skills. One of the key soft skills for an insurance examiner to have is communication skills. You can see how this relates to what insurance examiners do because "claims adjusters and investigators must get information from a range of people, including claimants, witnesses, and medical experts." Additionally, an insurance examiner resume shows how insurance examiners use communication skills: "act as examiner-in-charge (eic) on several of the noted examinations and responsible for communication with exam team. "
Interpersonal skills. Another soft skill that's essential for fulfilling insurance examiner duties is interpersonal skills. The role rewards competence in this skill because "adjusters, examiners, and investigators often meet with claimants and others who may be upset by the situation that requires a claim or by the settlement the company is offering." According to an insurance examiner resume, here's how insurance examiners can utilize interpersonal skills in their job responsibilities: "utilized strong interpersonal skills and phlebotomy expertise to schedule and conduct 208 home visits on my own. "
Analytical skills. A big part of what insurance examiners do relies on "analytical skills." You can see how essential it is to insurance examiner responsibilities because "adjusters and examiners must each evaluate whether the insurance company is obligated to pay a claim and determine the amount to pay." Here's an example of how this skill is used from a resume that represents typical insurance examiner tasks: "analyze and interpret financial data. "
Detail oriented. Another crucial skill for an insurance examiner to carry out their responsibilities is "detail oriented." A big part of what insurance examiners relies on this skill, since "adjusters, appraisers, examiners, and investigators must carefully review documents and damaged property, because small details can have large financial consequences." How this skill relates to insurance examiner duties can be seen in an example from an insurance examiner resume snippet: "obtain detailed medical history,ekg, phlebotomy for insurance policies. "
The three companies that hire the most insurance examiners are:
- Eide Bailly1 insurance examiners jobs
- GEICO1 insurance examiners jobs
- Swiss Reinsurance America Corporation1 insurance examiners jobs
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Compare different insurance examiners
Insurance examiner vs. Subrogation specialist
Property Claims Adjusters are individuals who evaluate the insurance claims of their clients. They specialize in the appraisal of property-related insurance claims such as damages or other concerns. They often work outside the office, typically always on fieldwork, since their job entails them to visit the property involved in the insurance claim. Property Claims Adjusters appraise the property, check the damages, evaluate whether the claims are valid, and provide their verdict. Insurance Claims on the property are adjusted based on their recommendations and final verdict. Property claims adjusters should be familiar with building codes, property laws, and insurance guidelines.
While similarities exist, there are also some differences between insurance examiners and subrogation specialist. For instance, insurance examiner responsibilities require skills such as "ekg," "financial statements," "blood pressure," and "health history." Whereas a subrogation specialist is skilled in "arbitration," "subrogation claims," "litigation," and "workers compensation." This is part of what separates the two careers.
The education levels that subrogation specialists earn slightly differ from insurance examiners. In particular, subrogation specialists are 3.6% less likely to graduate with a Master's Degree than an insurance examiner. Additionally, they're 1.7% more likely to earn a Doctoral Degree.Insurance examiner vs. Property claims adjuster
As a Total Loss Specialist, your job will involve appraising the damage and determining the salvage value on the total-loss vehicle. You will be tasked with examining the damaged vehicle to ascertain the extent of damage done to its body and structure and other mechanical, electrical, and internal damage. You'd also have to arrange with another appraiser to resolve any disagreement with the shop on the cost of repair after determining the extent of the damage to the vehicle.
In addition to the difference in salary, there are some other key differences worth noting. For example, insurance examiner responsibilities are more likely to require skills like "ekg," "financial statements," "blood pressure," and "health history." Meanwhile, a property claims adjuster has duties that require skills in areas such as "customer service," "good judgment," "little supervision," and "xactimate." These differences highlight just how different the day-to-day in each role looks.
Property claims adjusters earn a higher average salary than insurance examiners. But property claims adjusters earn the highest pay in the insurance industry, with an average salary of $58,172. Additionally, insurance examiners earn the highest salaries in the health care with average pay of $54,171 annually.Average education levels between the two professions vary. Property claims adjusters tend to reach similar levels of education than insurance examiners. In fact, they're 3.1% less likely to graduate with a Master's Degree and 1.7% less likely to earn a Doctoral Degree.Insurance examiner vs. Total loss specialist
Typically working for insurance companies, a property adjuster specializes in inspecting property damages to assess and determine a company's financial obligations. Their responsibilities revolve around reaching out to clients through calls and correspondence, arranging appointments, gathering and verifying data, and traveling to different locations to meet with clients. They may also negotiate settlements and authorize payments in adherence to the company's policies and regulations. Furthermore, as a property adjuster, it is essential to have a deep understanding of property costs to ensure the accuracy of claims.
The required skills of the two careers differ considerably. For example, insurance examiners are more likely to have skills like "ekg," "financial statements," "blood pressure," and "health history." But a total loss specialist is more likely to have skills like "customer service," "hr," "outbound calls," and "inbound calls."
Most total loss specialists achieve a similar degree level compared to insurance examiners. For example, they're 4.5% less likely to graduate with a Master's Degree, and 0.9% less likely to earn a Doctoral Degree.Insurance examiner vs. Property adjuster
Types of insurance examiner
Updated January 8, 2025
