Insurance & Superannuation

Insurance Claims Investigator

Insurance claims investigators evaluate insurance claims. They decide if the claim is valid, and how much the insurance company will pay.

  • Entry-level education

    Senior secondary school certificate or equivalent

  • Job outlook

    1 2 3 4 5

What does an Insurance Claims Investigator do?

Insurance claims investigators evaluate insurance claims. They decide if the claim is valid, and how much the insurance company will pay.

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Work activities

As an insurance claims investigator, you would:

  • examine claims forms and other records to determine insurance coverage
  • investigate and assess damage to property and create or review property damage estimates
  • interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review
  • review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability
  • negotiate claim settlements and recommend legal options when settlement cannot be negotiated
  • analyse the information gathered, and report findings and recommendations.
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Key skills and interests

To become an insurance claims investigator, you would need:

  • an aptitude for numbers and calculations
  • investigative and interviewing skills
  • sound judgement
  • attention to detail
  • good communication skills.
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Working hours and conditions

Working Hours

In a full-time job you would work standard hours, Monday to Friday.

Conditions

You would often work outside the office, inspecting property that was the subject of insurance claims, such as damaged buildings and vehicles.

You would need to drive to the claimant's location or the location of an incident, so would need a current drivers' licence.

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How to become an Insurance Claims Investigator?

Entry Level Education

A senior secondary school certificate or equivalent is typically required to work as an entry-level insurance investigator. In addition, you would need insurance-related work experience.

Increasingly, these types of roles require a bachelor’s degree and/or professional industry training.

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Job outlook

  • 1 2 3 4 5

Employment of insurance claims investigators is projected to grow slower than the average for all occupations.

As the number of vehicles increases, the number of insurance claims is also likely to increase. Demand for insurance claims investigators in property and casualty insurance is influenced by the number of natural disasters, such as floods and fires. Insurance officers in these areas may see strong employment growth as the number of natural disasters increases.

These factors will be somewhat offset by automation. Technology allows less complex claims to be processed automatically, which frees investigators to work on more complex claims. This means that fewer investigators are needed per claim, reducing the overall number of investigators.

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