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The Office of Career Services
Library Building, Room 429 & 430
222-05 56th Avenue
Bayside, NY 11364
Phone: (718) 631-6297

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Occupation Info


Insurance Claim Examiner

Overview: Claim examiners oversee the financial settlements of insurance claims to assure payments have been made in accordance with company practices. They investigate suspicious settlements and irregularities of claim payouts. They conduct statistical analyses of claims for patterns of fraud.
Duties: They investigate suspicious settlements of insurance claims to determine if there is a possibility of fraud committed by persons making claims or the insurance adjusters.

Statistically analyze records of fires or accidents to identify patterns that suggest specific persons are repeatedly collecting insurance payoffs for accidents or fires.

They recommend whether criminal charges should be brought against persons suspected of making fraudulent insurance claims or of committing arson.

They testify in court to present evidence against persons accused of criminal actions to collect insurance. Examples include: murder, arson or fake accidents.

Degree(s): A.A.S. Accounting 
A.A.S. Management: Marketing Concentration 
A.A.S. Management: Real Estate-Insurance Concentration 
A.S. Business Administration (Accounting and Marketing) 
Job Outlook: Employment of insurance claim examiners is expected grow as fast as average through 2018. Rising healthcare premiums and attempts by large insurance carriers to minimize costs will result in a greater need for claims examiners to more scrupulously review a growing number of medical claims.
Salary Range (National Average): $29,000 to $33,000
Education Level: Training for this occupation generally requires an Associate Degree from a 2 year or community college.
Additional Training/Education: Most insurance companies prefer to hire graduates with an associate or a bachelor's degree and a curriculum background in insurance, business administration and economics. Certification can be achieved through a variety of professional associations in the insurance industry. Most states require insurance adjusters to be licensed which involves passing a written examination.
Recommended Skills:
  • Weighing out the options in a situation or a problem and logically choosing the best course of action.
  • Paying attention to what other people are saying, and taking time to understand the points being made.
  • Allocating and budgeting your time for different tasks so that things get done when needed.
  • Using mathematics and/or statistics to solve problems.
  • Bringing people together to discuss and resolve differences.
  • Ability to identify a problem, review related information, develop and evaluate options, and implement a solution.
  • The ability to understand complex written paragraphs, instructions, or reports.
  • Using logic to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Talking, giving speeches, or speaking in a group to convey information, explain ideas, or give instructions.
  • Composing and communicating your ideas in written form.
Recommended Values:
  • Having a routine job where the duties are very predictable and not likely to change over a long period of time.
 

* National data collected by the Department of Labor between 2008-2012.
* For New York salary data information please click here
* For New York green job information please click here.

Understanding acquiring positions in this field may be enhanced through continuing academic study (i.e. earning a baccalaureate or a master's degree) and/or work experience in the field, Queensborough Community College has established transfer agreements with other institutions for students who wish to further pursue their educational goals. Students are highly encouraged to meet with one of our Career Services to fully understand the opportunities available through study in their degree program.