What does it take to become a claims adjuster for Life?

In an insurance company, claims adjusters can be promoted to the manager of the department or assistant to the manager, and the manager of the claims department can be transferred to other departments of the insurance company or promoted to a more senior administrative position. Outstanding performance can also go to other insurance companies to demand more attractive positions.

A bachelor's or associate degree in insurance, finance, accounting, law, economics or business is important for this position, as is a master's degree in management or economics or finance if you want to advance to a more senior position. Mathematics, computer, law, and language courses are helpful for this position, as are effective interpersonal communication, negotiation skills, and written skills.

Tasks: Interview or meet with plaintiffs and witnesses, consult police and hospital records, and inspect property damage to determine the extent of responsibility.

Investigate and estimate damage to property.

Check claim forms and other records to determine coverage.

The analysis information is gathered as a survey and reports the conclusions and recommendations.

When a settlement cannot be negotiated, a claim is negotiated and a lawsuit is proposed.

Prepare a report on the conclusions of the investigation.

Gather evidence in court to support the disputed claim.

Check that the authority given to the property is determined to be valid and act as a company ** person in the transaction with the owner.

Interview or meet with the person and the plaintiff to correct the error or omit and investigate the suspicious claim.

Introduce suspicious claims to investigators or claims adjusters for investigation or resolution.

I think if you want to enter an insurance company, the most important thing is to have a good network, which is what the company values, and it is best if you have strong social connections.

There are generally two types of life insurance claims adjusters, adjusters and investigators, or both. The adjuster is generally to review the materials submitted by the customer when making a claim, put forward the claim opinion, make a claim decision, calculate the claim amount, etc. The investigator uses various methods to find out the truth of the insured accident, distinguish the authenticity and provide a basis for the conclusion of the claim.

First of all, it is necessary to train, then to test what certificate, to take up the post, to do business, and finally to be promoted.

Relevant professional and legal knowledge is required.

1) Materials required for critical illness claims.

1.A copy of the application and insurance policy (list) (provided by the school or township education union);

2.A copy of the insured's ID card (front and back);

3.Certificate of Diagnosis of Illness from Hospital;

4.Examination reports (pathology report, electrocardiogram report, CT report or X-ray radiology report, etc.);

5.Outpatient medical records, inpatient medical records, and inpatient summaries;

6.The certificate issued by the unit (plus the opinions of the township education trade union, except for the schools directly under it);

7.A copy of the passbook (one of the four major state-owned banks of industry, agriculture, China and construction);

8.Other supporting materials required by the insurance company to confirm the nature and cause of the insured event.

2) Information required for accidental death and illness death claims.

1.A copy of the application and insurance policy (list) (provided by the school or township education union);

2.A copy of the insured's ID card (front and back);

3.The certificate issued by the unit (plus the opinions of the township education trade union, except for the schools directly under it);

4.Proof of beneficiary's identity;

5.Notarized certificate of beneficiary or power of attorney and power of attorney of beneficiary;

6.Death Certificate, Cremation Certificate or Certificate of Household Cancellation;

7.If the death is due to a traffic accident, a traffic accident certificate is also required;

8.A copy of the passbook (one of the four major state-owned banks of industry, agriculture, China and construction);

9.Other supporting materials required by the insurance company to confirm the nature and cause of the insured event.

The following documents are required for life insurance claims:

1. The application for insurance payment shall be filled in and signed by the insured;

2. Identification document of the insured;

3. Original insurance policy;

4. Receipt of the last payment;

5. Relevant information.

The specific claim process for life insurance is as follows:

1. Accepting the case, which refers to the process of the insurance accepting the customer's report and claim application after the insured has an insured accident;

2. Case filing, which refers to the process of the claims department of the insurance company accepting the customer's claim application and registering and numbering the claim case according to the relevant rules of the company, so that the case can enter the formal processing stage;

3. Preliminary examination, which is a process in which the claims adjuster conducts a preliminary review of the nature of the claim application case, the validity of the contract, and the claim materials;

4. Investigation, investigation refers to the process of verification and verification of insured accidents;

5. Adjusting: refers to the process of adjusters making payments, refusals, accommodations, exemptions, and calculating the amount of insurance benefits paid in the claim cases;

6. Case closure and filing: The case closure personnel shall carry out different processing according to the instructions of the claim file sent by the reviewers.

First of all, it depends on what type of insurance, what situation is claimed, and the claim information provided is different.

In the terms of the insurance contract, there is a special notice of the information required for the claim.

Information required for medical insurance, including student insurance:

1. Certificates (ID card, household registration booklet) and bank cards must be original;

2. Discharge records, medication lists, invoices;

3. Medical insurance reimbursement list.

2 and 3 must be stamped in red.

If it is a national life insurance or Corning critical illness insurance, it is also necessary to provide a pathology report.

In the case of life insurance and other death claims, you also need to provide a cremation certificate and a certificate of household registration cancellation, or a certificate issued by the village.

If you need more information about what you need to provide for a claim, you can also send me a private message.

1.Hospitalization invoices and social security statements are also acceptable.

2.List of Medications List of Expenses.

3.Discharge summary.

4.Medical records Proof of diagnosis.

5.If there are other channels for reimbursement, a claim notice is required.

The first thing an auto insurance claims adjuster needs is the "Insurance Adjuster Practitioner Qualification Certificate", followed by the "Insurance Adjuster Practitioner Grade Certificate". Note: Grade certificates are geographically restricted and not available nationwide. Qualifications are valid throughout the country. The training hours are as follows:

There are three main categories of auto insurance claims adjusters:

Normally, the auto insurance claims position of an insurance company is mainly divided into three categories: receiving the report, assessing the loss and verifying the claim. Different positions have different divisions of labor and different requirements for personnel.

Specifically, the post of receiving reports is also called the ** center, which is mainly divided into information registration of receiving reports, undertaking reports, inquiry, and accepting customer consultations. It is equivalent to the company's back office. "The company doesn't have very high requirements for people who work in this area.

Usually as long as you have a college degree or above, can handle daily computer word processing, and have a sweet voice. This type of personnel is not very mobile. Generally, you can start the job after 3 months of training.

The personnel who check the position of the loss assessor, that is, the loss assessor who often has direct contact with the customer, is commonly known as the claims adjuster. Responsible for going to the scene of the accident to assess and determine the loss. This kind of personnel is required to have a college degree or above in automobiles, and understand vehicles, automobile maintenance and related knowledge.

In addition, it is also necessary to be proficient in the knowledge of relevant laws and regulations such as motor vehicle insurance clauses and road traffic safety regulations. In addition to the above requirements, a high level of professional ethics is required. As the company's loss assessor, to a large extent, he is the representative of the company's rights and interests, and when customers have bad behaviors such as insurance fraud, they need to have a high ability to identify; For yourself, you should also have strong self-discipline and excellent character.

The claim verification position is responsible for the final verification and payment of the entire case and materials. This type of personnel has high comprehensive quality requirements and should be the core of the entire claims department. Therefore, in addition to having the abilities and requirements that damage assessors should have, they must also have an understanding of medical treatment, personal injury and other knowledge.

From the perspective of professional requirements, people in insurance, automobile, and medical-related majors can be considered.

In order to be able to put the post personnel in place, major insurance companies have taken perfect training measures. It only takes about half a year to train a professional loss adjuster.

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Typically, the materials required for a life insurance claim are mainly:

1) The application form for insurance payment shall be filled in and signed by the insured;

2. Identification document of the insured;

3) The original insurance policy of Baolu Shen, including the receipt of the last accompaniment.

Depending on the insurance company and the specific type of insurance, the claim materials will also be different.

Extended reading: [Insurance] How to buy, which one is better, teach you to avoid these insurance"pits"