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AccountancyISCO 3315

Loss adjuster

A loss adjuster is a person who handles and assesses insurance claims by investigating what happened and then establishing liability and damages against the terms of the insurer's policy. The claim arrives as an account from one side, and the adjuster's task is to turn it into a documented finding.

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Rate 5 of the 19 essential skills of this occupation (European ESCO data). No account needed.

manage claim files

present evidence

compile appraisal reports

review insurance process

document evidence

About loss adjuster

Investigation is where the skills show. The adjuster interviews claimants and witnesses, estimates the damage, assesses what the cover extends to, and consults damage experts where a technical opinion is needed. Insurance law sets the frame, actuarial science informs how exposure is quantified, and the principles of insurance decide which losses the policy was written to meet.

Writing it up follows. The adjuster prepares a report for the insurer with recommendations on settlement, presents the evidence that supports the finding, and puts forward settlement proposals. Payments to the insured against a claim are made as part of the handling, so the adjuster's figure becomes the amount that is actually paid.

The claimant has suffered a loss, and the adjuster stays in contact with them throughout the claim. The adjuster handles incoming claims, informs clients by telephone about where the matter stands, and explains a decision the claimant may not welcome.

European Skills Framework

Skills and knowledge areas required for this occupation based on European classification.

Essential (19)

insurance lawinsurance lawThe law and legislation concerning the policies of transferring risks or losses from one party, the insured, to another, the insurer, in exchange for a periodic payment. This includes the regulation o...principles of insuranceprinciples of insuranceThe understanding of the principles of insurance, including third party liability, stock and facilities.actuarial scienceactuarial scienceThe rules of applying mathematical and statistical techniques to determine potential or existing risks in various industries, such as finance or insurance.claims proceduresclaims proceduresThe different procedures that are used to formally request a payment for a suffered loss from an insurance company.types of insurancetypes of insuranceThe various types of risk or loss transfer policies that exist and their characteristics, such as health insurance, car insurance or life insurance.manage claim filesmanage claim filesFollow up on the progress of a claim file, keep all parties informed of the status of the file, ensure the customer receives the damages owed, treat any problems or complaints from customers, close th...present evidencepresent evidencePresent evidence in a criminal or civil case to others, in a convincing and appropriate manner, in order to reach the right or most beneficial solution.compile appraisal reportscompile appraisal reportsCompile full reports of appraisals of properties, businesses, or other goods and services being appraised using all the data gathered during the appraisal and valuation process, such as financial hist...review insurance processreview insurance processAnalyse all documentation related to a specific insurance case in order to ensure that the application for insurance or the claims process was handled according to guidelines and regulations, that the...document evidencedocument evidenceDocument all evidence found on a crime scene, during an investigation, or when presented in a hearing, in a manner compliant with regulations, to ensure that no piece of evidence is left out of the ca...check for damaged itemscheck for damaged itemsIdentify products that have been damaged and report the situation.handle incoming insurance claimshandle incoming insurance claimsManage, process and evaluate submitted requests for insurance in case a problem, which is covered under an insurance policy, occurs. The claim may or may not be approved, based on assessment of the ci...propose settlementspropose settlementsTake into account the damage appraisal or incident and injury reports in order to suggest a settlement to insurance professionals which would settle the claim with the claimant, such as estimating rep...manage claims processmanage claims processManage the relation with an insurer related to its obligation to receive, investigate and act on a claim filed by an insured.estimate damageestimate damageEstimate damage in case of accidents or natural disasters.negotiate settlementsnegotiate settlementsNegotiate with insurance companies and insurance claimants in order to facilitate agreement on a settlement which the insurance company has to provide for the claimant, such as covering repair costs f...assess coverage possibilitiesassess coverage possibilitiesExamine the reports dealing with damage appraisal or injury examination in order to verify whether the insured's damages or injuries are covered in their insurance policies, and if they are to assess ...interview insurance claimantsinterview insurance claimantsInterview people who have filed claims with the insurance corporation they are insured with, or through specialised insurance agents or brokers, in order to investigate the claim and the coverage in t...organise a damage assessmentorganise a damage assessmentOrganise a damage assessment by indicating an expert to identify and examine the damage, give information and instructions to experts and follow up on the experts, and write a damage report.
Optional (18) — show
fraud detectionfraud detectionThe techniques used to identify fraudulous activities.collect property financial informationcollect property financial informationCollect information concerning the previous transactions involving the property, such as the prices at which the property had been previously sold and the costs that went into renovations and repairs,...investigate occupational injuriesinvestigate occupational injuriesAssess, manage, and report cases of occupational illness, disease, or injury, establishing if this is a single case or if there is wider incidence.prepare financial auditing reportsprepare financial auditing reportsCompile information on audit findings of financial statements and financial management in order to prepare reports, point out improvement possibilities, and confirm governability.create a financial plancreate a financial planDevelop a financial plan according to financial and client regulations, including an investor profile, financial advice, and negotiation and transaction plans.create cooperation modalitiescreate cooperation modalitiesPrepare, determine and agree on the conditions for cooperation contracts with a company, by comparing products, following evolutions or shifts in the market and negotiating terms and prices.obtain financial informationobtain financial informationGather information on securities, market conditions, governmental regulations and the financial situation, goals and needs of clients or companies.advise on insurance policiesadvise on insurance policiesAdvise on specific contracts and general insurance guidelines, such as the terms of coverage, the risks that are involved, the handling of claims, and terms of settlements.conduct financial auditsconduct financial auditsEvaluate and monitor the financial health, the operations and financial movements expressed in the financial statements of the company. Revise the financial records to ensure stewardship and governabi...provide information on propertiesprovide information on propertiesProvide information on the positive and negative aspects of a property and the practicalities concerning any financial transactions or insurance procedures; such as location, composition of the proper...listen to the stories of the disputantslisten to the stories of the disputantsListen to the arguments of the parties involved in disputes in order to clarify misunderstandings and miscommunications among them.ensure cross-department cooperationensure cross-department cooperationGuarantee communication and cooperation with all the entities and teams in a given organisation, according to the company strategy.identify damage to buildingsidentify damage to buildingsMonitor the state of building exteriors in order to identify any possible damage and to assess the nature of the damage and treatment methods.assess customer credibilityassess customer credibilityCommunicate with customers to assess whether their true intentions are in line with what they claim in order to eliminate any risks from a potential agreement with the customer.determine cause of damagedetermine cause of damageRecognise damage and signs of corrosion, identify their cause and determine maintenance and repair procedures.analyse financial riskanalyse financial riskIdentify and analyse risks that could impact an organisation or individual financially, such as credit and market risks, and propose solutions to cover against those risks.classify insurance claimsclassify insurance claimsProcess incoming claims in order to assess their nature and categorise them according to the different types of insurance and claims handling procedures, in order to ensure proper administrative handl...manage contract disputesmanage contract disputesMonitor issues that arise between the parties involved in a contract and provide solutions in order to avoid lawsuits.

Related Occupations

Occupations that need many of the same essential skills, so the move between them is shortest.

insurance claims handler10 shared essential skillsinsurance claims manager8 shared essential skillsproperty insurance underwriter8 shared essential skillsinsurance fraud investigator7 shared essential skillsinsurance underwriter6 shared essential skillsinsurance broker5 shared essential skillsinsurance risk consultant5 shared essential skillsinsurance agency manager4 shared essential skills

Frequently asked questions

What does a loss adjuster do?

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.

What skills does a loss adjuster need?

A loss adjuster needs 19 essential skills, including insurance law, principles of insurance, actuarial science, claims procedures, types of insurance.

Will AI replace loss adjuster jobs?

The AI disruption score for loss adjuster is 57/100 (high risk). Skills most exposed to automation: collect property financial information, handle incoming insurance claims, claims procedures. Most resilient: listen to the stories of the disputants, negotiate settlements, present evidence.

AI Replacement Risk

57/ 100
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Quick Facts

SectorAccountancy
ISCO GroupBusiness and administration associate professionals
Essential Skills19

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