详情介绍
中文
12201 – 保险理算员和理赔审查员
保险理算员调查保险索赔并确定保险单所涵盖的损失或损害金额。他们受雇于保险公司的理赔部门或担任独立理算员。保险索赔审查员检查保险理算员调查的索赔并授权付款。他们受雇于保险公司的总部或分支机构。
标题索引
- 调节器
- 调节器 - 保险
- 理算员实习生 - 保险
- 汽车理赔技术调整员
- 伤亡保险理算员
- 理赔员 - 保险
- 索赔批准人 - 保险
- 理赔顾问
- 理赔审查员
- 理赔审查员 - 保险
- 理赔调查员
- 理赔调查员 - 保险
- 理赔代表
- 索赔代表 - 保险
- 残疾索赔审查员 - 保险
- 救灾理赔人 - 保险
- 现场调节器 - 保险
- 火险理算员
- 运费理算员-保险
- 团体人寿理赔审查员 - 保险
- 健康和牙科理赔审查员 - 保险
- 保险理算员
- 保险督察
- 责任调节器 - 保险
- 损失审查员 - 保险
- 海事理赔员 - 保险
- 海上保险理算员
- 医疗索赔评估员 - 保险
- 机动车理赔员 - 保险
- 生产检验员
- 财产调整员 - 保险
- 公共调解员 - 保险
- 铁路理赔理算员 - 保险
- 结算管理助理
- 入驻专员
- 工作人员调整员 - 保险
- 电话调节器 - 保险
- 见习调解员 - 保险
- 工伤赔偿调整员 - 保险
主要职责
该小组履行以下部分或全部职责:
保险理算员
- 调查保险索赔的情况以确定索赔的有效性
- 检查汽车、房屋或其他财产的损坏
- 获取声明并咨询索赔人、事故证人、医生和其他相关人员,并检查记录或报告
- 确定保险单所涵盖的损失或损害金额
- 协商理赔
- 准备调整报告。
保险理赔审查员
- 审查、检查、计算和授权保险理算员调查的保险索赔
- 检查理算员的报告和类似的保险索赔或先例以确定保险范围
- 确保索赔有效并根据公司惯例和程序进行结算
- 咨询律师、医生或其他相关人士讨论保险理赔事宜
- 批准汽车、火灾、人寿、伤残、牙科或其他保险索赔。
就业要求
- 必须完成中学学业。
- 需要学士学位、大专文凭或一定程度的专上教育,或者在理赔部门担任文员的多年经验或其他一般保险经验。
- 需要几年的在职培训和完成保险业课程和培训计划。
- 独立理算师需要持有由保险总监在就业所在省或地区颁发的省级执照。
附加信息
- 通过加拿大保险协会或其省级同行完成教育课程后,保险理算员和理赔审查员将获得专业认可,成为特许保险专业人员 (CIP),并通过额外的大学课程,成为特许保险专业人员 (FCIP)。
排除
English
12201 – Insurance adjusters and claims examiners
Insurance adjusters investigate insurance claims and determine the amount of loss or damages covered by insurance policies. They are employed in claims departments of insurance companies or as independent adjusters. Insurance claims examiners examine claims investigated by insurance adjusters and authorize payments. They are employed at head offices or branches of insurance companies.
Index of titles
- Adjuster
- Adjuster - insurance
- Adjuster trainee - insurance
- Automobile claims technical adjuster
- Casualty insurance adjuster
- Claims adjuster - insurance
- Claims approver - insurance
- Claims consultant
- Claims examiner
- Claims examiner - insurance
- Claims investigator
- Claims investigator - insurance
- Claims representative
- Claims representative - insurance
- Disability claims examiner - insurance
- Disaster relief claims adjuster - insurance
- Field adjuster - insurance
- Fire insurance adjuster
- Freight adjuster - insurance
- Group life claims examiner - insurance
- Health and dental claims examiner - insurance
- Insurance adjuster
- Insurance inspector
- Liability adjuster - insurance
- Loss examiner - insurance
- Marine claims adjuster - insurance
- Marine insurance adjuster
- Medical claims assessor - insurance
- Motor vehicle claims adjuster - insurance
- Production examiner
- Property adjuster - insurance
- Public adjuster - insurance
- Railroad claims adjuster - insurance
- Settlement management associate
- Settlement specialist
- Staff adjuster - insurance
- Telephone adjuster - insurance
- Trainee adjuster - insurance
- Workers' compensation adjuster - insurance
Main duties
This group performs some or all of the following duties:
Insurance adjusters
- Investigate circumstances surrounding insurance claims to determine validity of claim
- Inspect automobile, home or other property damage
- Take statements and consult with claimants, accident witnesses, doctors and other relevant individuals and examine records or reports
- Determine amount of loss or damages covered by insurance policies
- Negotiate settlement of claims
- Prepare adjustment reports.
Insurance claims examiners
- Review, examine, calculate and authorize insurance claims investigated by insurance adjusters
- Examine adjusters' reports and similar insurance claims or precedents to determine extent of insurance coverage
- Ensure claims are valid and settlements are made according to company practices and procedures
- Consult lawyers, doctors or other relevant individuals to discuss insurance claims
- Approve automobile, fire, life, disability, dental or other insurance claims.
Employment requirements
- Completion of secondary school is required.
- A bachelor's degree, college diploma or some post-secondary education or several years of experience as a clerk in the claims department or other general insurance experience is required.
- Several years of on-the-job training and completion of insurance industry courses and training programs are required.
- Independent adjusters require a provincial licence issued by the Superintendent of Insurance in the province or territory of employment.
Additional information
- Completion of educational programs through the Insurance Institute of Canada or its provincial counterparts entitles insurance adjusters and claims examiners to professional recognition as a Chartered Insurance Professional (CIP), and with additional university courses, as a Fellow Chartered Insurance Professional (FCIP).