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1312 保险理算员和索赔审查员 Insurance Adjusters and Claims Examiners

1312 保险理算员和索赔审查员 Insurance Adjusters and Claims Examiners

保险理算员调查保险索赔和确定保单所涵盖的损失或损害的数额。他们受雇于保险公司的理赔部门,或作为独立的理算员。保险索赔审查员检查由保险理算员调查过的索赔,并授权付款。他们受雇于保险公司的总部或分支机构。

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.

 

1312 保险理算员和索赔审查员头衔范例 Example Titles

 

理算员 adjuster
索赔审查员 claims examiner
索赔代表 claims representative
保险理算员 insurance adjuster

 

1312 保险理算员和索赔审查员主要职责 Main duties

 

保险理算员执行部分或全部下列职责:Insurance adjusters perform some or all of the following duties:

调查保险理赔的情况,确定索赔的有效性
Investigate circumstances surrounding insurance claims to determine validity of claim

检查汽车,家庭或其他财产损失
Inspect automobile, home or other property damage

录取口,咨询索赔者,事故目击者,医生和其他有关人士,检查记录或报告
Take statements and consult with claimants, accident witnesses, doctors and other relevant individuals and examine records or reports

确定保单所涵盖的损失或损害赔偿金额
Determine amount of loss or damages covered by insurance policies

协商解决索赔
Negotiate settlement of claims

准备理算报告。
Prepare adjustment reports.

保险索赔检查员执行部分或全部下列职责:Insurance claims examiners perform some or all of the following duties:

审查,检查,计算,并授权由保险理算员调查的保险索赔
Review, examine, calculate and authorize insurance claims investigated by insurance adjusters

检查理算员的报告和类似的保险索赔或先例,以确定保险保障程度
Examine adjusters' reports and similar insurance claims or precedents to determine extent of insurance coverage

确保索赔的有效性,按照公司常规及程序进行结算
Ensure claims are valid and settlements are made according to company practices and procedures

咨询律师,医生或其他有关人士,讨论保险理赔
Consult lawyers, doctors or other relevant individuals to discuss insurance claims

批准汽车,消防,生活,残疾,牙科或其他保险索赔。
Approve automobile, fire, life, disability, dental or other insurance claims.

 

1312 保险理算员和索赔审查员任职要求 Employment requirements

 

必需完成中学学业。
Completion of secondary school is required.

大学本科学历,大专以上文凭或中学后教育
A bachelor's degree, college diploma or some post-secondary education

或多年的理赔部门业务员经验,或其他一般保险经验。
Several years of experience as a clerk in the claims department or other general insurance experience are required.

必需具备多年的在职培训以及保险业课程和培训计划。
Several years of on-the-job training and completion of insurance industry courses and training programs are required.

独立理算员要求具备由就业省份或地区保险监督官颁发的省级许可证。
Independent adjusters require a provincial licence issued by the Superintendent of Insurance in the province or territory of employment.

 

1312 保险理算员和索赔审查员附加信息 Additional information

 

完成加拿大保险协会的教育计划,或其省级同行赋予保险理算员和索赔审查员作为特许保险专业(CIP)的专业人士,作为特许保险专业研究员(FCIP),还需要学习更多的其他大学课程。
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).

 

1312 保险理算员和索赔审查员其他分类 Classified elsewhere

 

主管,金融和保险工作人员 Supervisors, finance and insurance office workers 1212(1212)

 

1312 保险理算员和索赔审查员职称头衔 All titles

 

理算员 adjuster
理算员 - 保险 adjuster – insurance
见习理算员 - 保险 adjuster trainee – insurance
汽车索赔技术理算员 automobile claims technical adjuster
意外伤害保险理算员 casualty insurance adjuster
理赔 - 保险 claims adjuster – insurance
索赔审批 - 保险 claims approver – insurance
理赔顾问 claims consultant
索赔审查员 claims examiner
索赔审查员 - 保险 claims examiner – insurance
理赔调查员 claims investigator
理赔调查员 - 保险 claims investigator – insurance
声称代表 claims representative
声称代表 - 保险 claims representative – insurance
伤残索赔检查员 - 保险 disability claims examiner – insurance
救灾理赔 - 保险 disaster relief claims adjuster – insurance
现场理算员 - 保险 field adjuster – insurance
火灾保险公估 fire insurance adjuster
货运理算员 - 保险 freight adjuster – insurance
团体寿险索赔审查员 - 保险 group life claims examiner – insurance
健康和牙科的索赔审查员 - 保险 health and dental claims examiner – insurance
保险理算员 insurance adjuster
保险巡视员 insurance inspector
负债理算员 - 保险 liability adjuster – insurance
损失检查员 - 保险 loss examiner – insurance
海洋理赔员 - 保险 marine claims adjuster – insurance
船舶保险公估 marine insurance adjuster
医疗估损 - 保险 medical claims assessor – insurance
机动车辆理赔 - 保险 motor vehicle claims adjuster – insurance
产品检查员 production examiner
物业理算员 - 保险 property adjuster – insurance
公共理算员 - 保险 public adjuster – insurance
铁路理赔员 - 保险 railroad claims adjuster – insurance
结算管理联营公司 settlement management associate
结算专家 settlement specialist
人员理算员 - 保险 staff adjuster – insurance
电话理算员 - 保险 telephone adjuster – insurance
见习理算员 - 保险 trainee adjuster – insurance
工人补偿理算员 - 保险 workers' compensation adjuster – insurance

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