Denies, settles, or authorizes payments to routine property/casualty claims based on coverage, appraisal, and verifiable damage.
Corresponds with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested insurance claims. Makes recommendations for settlement of routine property/casualty claims based on coverage, appraisal, and verifiable damage. Prepares reports of investigation findings. May conduct field evaluations to inspect and document damage or loss.
Salary.com identifies five increasing levels of proficiency for each skill/competency. Some jobs require only a relatively low level of proficiency in each skill/competency, while other jobs will require a more advanced level of proficiency in the same skill/competency. These levels rate the degree of proficiency (skill level, expertise) we expect the incumbent to perform in the given skill/competency for the given job. Note that we intentionally do not associate timeframes or years of experience in performing the skill/competency because that can be misleading. Proficiency levels identify what the incumbent knows and can do rather than how long they have been doing it. Also, note that the proficiency levels are cumulative, e.g., a level 4 proficiency implies the ability to perform all the behaviors at the lower levels.
Check each Claims Adjuster I - P&C skill and competencie below to view definitions.
Skill definition-Applying knowledge of the insurance industry to provide risk management services and protection to various individuals from financial loss.
Level 1 Behaviors
(General Familiarity)
Describes the current systems and scope of services provided by insurance organizations.
Level 2 Behaviors
(Light Experience)
Follows industry best practices when preparing reports that detail risk assessment findings in insurance claims.
Level 3 Behaviors
(Moderate Experience)
Makes necessary adjustments to insurance policies to meet customer needs.
Level 4 Behaviors
(Extensive Experience)
Handles complex insurance losses through negotiation of favorable claims settlements with insurance companies.
Level 5 Behaviors
(Mastery)
Develops and establishes risk reduction best practices to prevent fraudulent claims transactions.
Skill definition-Creating, executing, and adhering to state and federal laws governing insurance operations to ensure financial security and consumer protection.
Level 1 Behaviors
(General Familiarity)
Describes the basic structure of insurance legal and regulatory environment.
Level 2 Behaviors
(Light Experience)
Complies with insurance legal and regulatory principles to safeguard the rights and interests of the insured.
Level 3 Behaviors
(Moderate Experience)
Analyzes existing legal and regulatory standards to address errors affecting insurance policies.
Level 4 Behaviors
(Extensive Experience)
Improves legal procedures for licensing intermediaries or producers to prevent penalties.
Level 5 Behaviors
(Mastery)
Designs compliance strategies and programs to prevent violations of statutes, regulations, and policies.
Skill definition-Creating mutually beneficial relationships with customers to improve their overall experience.
Level 1 Behaviors
(General Familiarity)
Cites examples of advantages and disadvantages of customer relationships.
Level 2 Behaviors
(Light Experience)
Assists in creating customer loyalty programs that fosters customer relations.
Level 3 Behaviors
(Moderate Experience)
Aligns our values with the customer relationship management framework to create positive interactions.
Level 4 Behaviors
(Extensive Experience)
Designs and manages programs that promote and maintain collaborative relationships with customers.
Level 5 Behaviors
(Mastery)
Builds strategic action plans to improve the overall process of customer relationship management.
Skill definition-Accumulating necessary information from various resources to clarify the situation or make an informed business decision.
Level 1 Behaviors
(General Familiarity)
Cites examples of methods used to collect and compile information.
Level 2 Behaviors
(Light Experience)
Applies techniques and tools to gather, organize, and archive pertinent information.
Level 3 Behaviors
(Moderate Experience)
Analyzes employees' feedback to determine necessary changes to be implemented within our business.
Level 4 Behaviors
(Extensive Experience)
Implements strategies to streamline the data collection process.
Level 5 Behaviors
(Mastery)
Creates confidentiality agreements to ensure accurate submission of information from employees.
Skill definition-A set of written instructions that describes the step-by-step activities to complete tasks in compliance with business standards and industry regulations.
Level 1 Behaviors
(General Familiarity)
Cites examples of SOP practices in our business operations.
Level 2 Behaviors
(Light Experience)
Assists in the preparation of internal standard operating procedures (SOP).
Level 3 Behaviors
(Moderate Experience)
Ensures internal SOPs are in compliance with industry standards and regulations.
Level 4 Behaviors
(Extensive Experience)
Develops and delivers training programs to ensure our SOPs are fully communicated and adhered to.
Level 5 Behaviors
(Mastery)
Champions the adoption of SOP to foster efficiency and consistency.
There are 11 hard skills for Claims Adjuster I - P&C, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
1 general skills for Claims Adjuster I - P&C, Customer Relations.
7 soft skills for Claims Adjuster I - P&C, Gathering Information, Standard Operating Procedures (SOP), Attention to Detail, etc.
While the list totals 19 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Claims Adjuster I - P&C, he or she needs to be proficient in Gathering Information, be proficient in Standard Operating Procedures (SOP), and be proficient in Attention to Detail.
