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What does an Insurance Auditor do?

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  • Written By: Keith Koons
  • Edited By: Lauren Fritsky
  • Last Modified Date: 25 November 2016
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    2003-2016
    Conjecture Corporation
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An insurance auditor is a professional that is tasked with determining the validity of claims that are submitted to insurance companies for payment. Not only does this individual have to visually inspect and verify any statements made by each party during the claims process, but he often needs to communicate with experts in order to determine the validity of the testimony given. Another aspect of being an insurance auditor is determining fair valuation for anything lost or damaged by an insurance company's clients so compensation can be made. There are many different types of insurance auditors that specialize in almost every valuable commodity sold on the planet.

Perhaps the most familiar insurance auditor would be one that works with the automotive industry. When a vehicular accident occurs, the auditor would inspect the vehicles in question to determine the cause of the crash, how much physical damage is present, and any other factors that could be related. This process normally requires the insurance auditor to speak with the police and any other witnesses to ensure that the claim is valid, and from that point, a settlement would be generated based on the extent of the damages. With hundreds of separate factors to consider and thousands of parts on every automobile, this type of auditor generally stays very busy.

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Within almost any industry, there is normally a small amount of insurance claims that are fraudulent. Another part of an insurance auditor's daily responsibilities is to investigate fraud and to work alongside law enforcement when criminal intentions are suspected. An insurance auditor that deals with rare art, for example, could save his company millions of dollars each year by noticing subtle problems while processing claims, because often these types of crimes are very well thought out and difficult to prove. The banking industry also sees a large amount of fraud by consumers who deny transactions on their account were authorized, and these types of cases often lead to criminal prosecution. In some of these cases, the insurance adjuster ends up being the star witness for the prosecution once the incident goes to trial.

The position of an insurance adjuster is rarely about catching notorious criminals, though, and on an average day, a single adjuster may be required to handle half a dozen or more standard cases. Most of the workday is dedicated to evaluating monetary losses over the telephone or the Internet with several hours of driving involved while gathering evidence and processing each claim. This type of career is normally paid on a "per job" basis, meaning that the insurance adjuster's overall efficiency will determine the size of his average paycheck.

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