1312 – Insurance adjusters and claims examiners

1312 – Insurance adjusters and claims examiners

1312 – Insurance adjusters and claims examiners

Professionals classified under NOC 1312 play a vital role in the insurance sector, ensuring fair, accurate, and timely assessment of claims. Whether it involves property damage, personal injury, automobile collisions, or commercial losses, insurance adjusters and claims examiners help determine the extent of liability and the appropriate settlement. As the insurance industry continues to expand across Canada, these skilled professionals remain in high demand.

Canada’s labour market also recognizes the importance of occupations such as insurance adjusters. With evolving immigration systems like the CRS Points System 2025, skilled professionals in the insurance field can explore various opportunities for long-term career growth and settlement. The profession requires a balance of investigative skills, communication abilities, and expertise in understanding policies and regulations.

Profile Overview of 1312 – Insurance Adjusters and Claims Examiners

Insurance adjusters investigate claims submitted by policyholders to determine the amount that the insurer should pay. They inspect damages, gather evidence, interview witnesses, and negotiate settlements. Claims examiners, meanwhile, review and approve the decisions made by adjusters, ensuring compliance with company policies, legal requirements, and industry standards.

These professionals may work for insurance companies, independent adjusting firms, financial institutions, government agencies, and legal service firms. Some adjusters may also operate independently, providing contracted assessment services on behalf of multiple insurers.

Main Duties of Insurance Adjusters and Claims Examiners

The responsibilities of workers under NOC 1312 are extensive and require sharp analytical and investigative skills. Typical duties include:

1. Investigating Insurance Claims

Adjusters gather detailed information related to the claim. This involves inspecting damaged property, reviewing police or medical reports, interviewing clients or witnesses, and analyzing photographs or videos. Their goal is to confirm the event, determine liability, and estimate losses.

2. Evaluating Damages and Losses

Once the investigation is complete, adjusters calculate the financial value of the loss. They may work with contractors, repair specialists, medical professionals, or legal teams to ensure damages are accurately assessed.

3. Negotiating Settlements

Adjusters negotiate with policyholders, lawyers, or third parties to reach a fair settlement. They ensure that claims fall within the coverage limits of the insurance policy and comply with company guidelines.

4. Reviewing and Approving Claims

Claims examiners evaluate the work of adjusters to ensure accuracy and fairness. They approve, modify, or decline claims based on evidence and policy conditions.

5. Maintaining Detailed Records

Accurate documentation is essential. Adjusters maintain reports, communication logs, receipts, photographs, and settlement records to support the final decision.

6. Advising Policyholders

Professionals may explain claim procedures, coverage details, required documentation, and timelines to clients. Clear communication helps avoid misunderstandings and ensures a smoother claims process.

7. Identifying Fraudulent Claims

Fraud prevention is crucial in the insurance industry. Adjusters must carefully examine inconsistencies, verify statements, and flag suspicious activity for further investigation.

Skills and Competencies Required

Insurance adjusters and claims examiners must demonstrate a diverse skill set, including:

  • Analytical thinking: Ability to evaluate complex situations, damages, and evidence.

  • Communication skills: Interacting professionally with clients, contractors, and legal experts.

  • Negotiation capabilities: Ensuring fair settlements while representing the insurer’s interests.

  • Attention to detail: Reviewing documents, policies, and reports with precision.

  • Decision-making skills: Making sound judgments based on facts and regulations.

  • Technical knowledge: Familiarity with building structures, auto repairs, healthcare billing, or personal injury assessments depending on the claims area.

  • Computer literacy: Using claims management software, digital reporting tools, and databases.

These skills support successful performance in a fast-paced and highly regulated environment.

Work Settings and Employment Opportunities

Professionals in insurance adjusting and claims examination work in:

  • Home, auto, and commercial insurance companies

  • Financial service institutions

  • Independent adjusting firms

  • Government agencies

  • Legal offices

  • Risk management departments

The role may involve office work, fieldwork, or a combination of both. Many adjusters travel to claim sites, especially during natural disasters or large-scale incidents.

Career Growth and Advancement

The insurance sector offers diverse opportunities for career progression. With experience, adjusters can advance into roles such as:

  • Senior Claims Examiner

  • Claims Manager

  • Loss Control Specialist

  • Underwriter

  • Risk Manager

  • Insurance Investigator

  • Branch Manager

Specialized certifications in property claims, auto claims, liability, or medical claims can enhance career prospects and earning potential.

Pathways for International Professionals

Skilled insurance adjusters and claims examiners may explore work opportunities through Canadian immigration programs. Occupations related to investigation and financial assessment can be recognized within Canada’s labour needs, and in some cases, candidates with specialized skills may qualify through employer-driven pathways like the Canada Global Talent Stream when applicable in related fields that require advanced technical expertise.

Canada continues to experience demand for professionals who can support the insurance sector, especially with increasing climate-related events leading to more property and disaster claims. As a result, experienced adjusters can find strong employment prospects across multiple provinces.

Exclusions

Some roles are separate from NOC 1312 and fall under different classifications, including:

  • Insurance underwriters

  • Insurance brokers and agents

  • Appraisers with specialized fields such as auto or property appraisals

  • Investigators not working specifically with insurance claims

Understanding these distinctions ensures accurate classification for immigration and employment purpose

 

 






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