Claims Adjuster

O*NET: Claims Adjusters, Examiners, and Investigators·13-1031.00

The Verdict:Claims adjusting heavily involves reviewing documents, analyzing liability, and routine payouts—areas where AI excels and is taking over. Humans handle negotiations, complex disputes, and in-person assessments where judgment and rapport ensure fair outcomes. AI evaluation tools advance rapidly, reshaping the role with fewer needed for standard cases.

Resilience Score

/100

Moderate Risk

Score tiers

Highly Resilient81–100

Resilient61–80

Moderate Risk41–60

High Risk21–40

Critical Risk0–20

How is this scored?

Task Resilience

How much of this role's daily work remains beyond AI and robotic automation.

30% of score

Physical Presence

The degree to which this job needs a human present — hands-on, in the field, or in the room.

20% of score

Human Necessity

How important the unique human edge is — for trust, accountability, or judgment.

15% of score

Regulatory Shield

How strong the legal requirement is for a human in this job (by law, licensing, or credentials).

13% of score

Technological Maturity

How far AI remains from performing this role's core functions.

10% of score

Displacement Evidence

The volume of jobs in this field being eliminated by AI or automation right now.

12% of score

Score last updated: February 2026Full methodology

Avg Salary

Median annual wage from the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS), May 2024 release.

$77k

Job Growth (10yr)

Projected change in total number of jobs (not salary) from 2024–2034. Source: Bureau of Labor Statistics Employment Projections.

-5%

AI Exposure

Percentage of this role's analyzed tasks that AI can handle autonomously or nearly so. 6 of 29 tasks are classified as AI-exposed.

21%

Low exposure

Task Analysis

This role has a mixed AI profile.
6 tasks are automatable, 41% reward AI fluency, and 11 remain human-essential.

6exposed

12AI leverage

11human-essential

View all 29 tasks

AI Can Handle This6 tasks

Tasks AI can do autonomously or nearly so

Pay and process claims within designated authority level.

Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.

Report overpayments, underpayments, and other irregularities.

Prepare reports to be submitted to company's data processing department.

Obtain credit information from banks and other credit services.

AI Leverage12 tasks

Master these tools — humans who do outperform those who don't

Examine claims forms and other records to determine insurance coverage.

Analyze information gathered by investigation and report findings and recommendations.

Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.

Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.

Investigate and assess damage to property and create or review property damage estimates.

Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

Refer questionable claims to investigator or claims adjuster for investigation or settlement.

Conduct detailed bill reviews to implement sound litigation management and expense control.

Communicate with reinsurance brokers to obtain information necessary for processing claims.

Examine titles to property to determine validity and act as company agent in transactions with property owners.

Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.

Human Advantage11 tasks

Tasks requiring trust, presence, or novel judgment

Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.

Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.

Resolve complex, severe exposure claims, using high service oriented file handling.

Confer with legal counsel on claims requiring litigation.

Collect evidence to support contested claims in court.

Contact or interview claimants, doctors, medical specialists, or employers to get additional information.

Present cases and participate in their discussion at claim committee meetings.

Attend mediations or trials.

Supervise claims adjusters to ensure that adjusters have followed proper methods.

Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.

Resilience Landscape

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