Will claims adjusters be replaced by AI?
Updated
Claims adjusters score 56 of 100 for AI exposure. The largest share of their task time, 70%, is work AI speeds up while they stay in charge. AI can take over 27% outright, and 3% stays with people.
- 27% AI can do it
- 70% AI helps
- 3% Needs a person
High exposure
Higher than 86% of the 923 occupations we scored.
Task by task
We graded 29 tasks, listed here from most to least exposed. AI can do 8 of them today, speeds up 20 and leaves 1 to people.
| Task | AI exposure |
|---|---|
| Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. Routine system entry and file notes; AI does, person spot-checks. | 82% AI can do it |
| Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. Records upkeep and inventory tracking is largely automatable software work. | 78% AI can do it |
| Prepare reports to be submitted to company's data processing department. Generating structured reports from claims data is highly automatable. | 75% AI can do it |
| Refer questionable claims to investigator or claims adjuster for investigation or settlement. Routing flagged claims by fixed rules is easily automated. | 70% AI can do it |
| Conduct detailed bill reviews to implement sound litigation management and expense control. Medical and legal bills checked against rules; reviewer signs off. | 70% AI can do it |
| 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. Cross-checking claim data against rules is highly automatable. | 65% AI can do it |
| Report overpayments, underpayments, and other irregularities. AI detects discrepancies and drafts reports; a person reviews. | 65% AI can do it |
| Pay and process claims within designated authority level. Routine processing runs automatically; people approve amounts above limits. | 62% AI can do it |
| Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. AI can extract and summarize records; liability call stays human. | 60% AI helps |
| Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments. AI flags anomalies in files; people authorize questionable payments. | 58% AI helps |
Show the other 19 tasks
| Task | AI exposure |
|---|---|
| Examine claims forms and other records to determine insurance coverage. AI reads policies and forms; adjuster confirms coverage. | 55% AI helps |
| Analyze information gathered by investigation and report findings and recommendations. AI summarizes findings and drafts reports; investigator leads judgment. | 55% AI helps |
| Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. AI can model reserve ranges; policy and judgment calls remain human. | 50% AI helps |
| Obtain credit information from banks and other credit services. Database lookups automate well; bank contact and consent need people. | 50% AI helps |
| Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. AI drafts correspondence; live interviews and disputes need people. | 45% AI helps |
| Collect evidence to support contested claims in court. AI gathers and organizes documents; courtroom evidence work needs people. | 42% AI helps |
| Communicate with reinsurance brokers to obtain information necessary for processing claims. AI drafts broker emails and tracks requests; relationships stay human. | 42% AI helps |
| 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. Broad role mixing analysis with live claimant relationships. | 40% AI helps |
| Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. AI can draft outreach and summarize replies; interviews stay human. | 40% AI helps |
| Examine titles to property to determine validity and act as company agent in transactions with property owners. AI reviews title records; signing and owner dealings stay human. | 40% AI helps |
| Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit. Automated verification services and email help; phone calls need people. | 38% AI helps |
| Investigate and assess damage to property and create or review property damage estimates. Estimating software and photo AI help; site inspection needs people. | 35% AI helps |
| Contact or interview claimants, doctors, medical specialists, or employers to get additional information. AI drafts requests and summarizes records; live contact stays human. | 35% AI helps |
| Present cases and participate in their discussion at claim committee meetings. AI can prepare case decks; presenting and debating stays human. | 30% AI helps |
| Resolve complex, severe exposure claims, using high service oriented file handling. AI preps file summaries; complex negotiation and service stay human. | 25% AI helps |
| Supervise claims adjusters to ensure that adjusters have followed proper methods. AI audits adjuster files; supervision and coaching stay human. | 25% AI helps |
| Confer with legal counsel on claims requiring litigation. AI preps case summaries; live counsel discussions stay with people. | 22% AI helps |
| Negotiate claim settlements or recommend litigation when settlement cannot be negotiated. AI models offer ranges; live negotiation stays with the adjuster. | 22% AI helps |
| Attend mediations or trials. Attending hearings and trials requires being physically present. | 8% Needs a person |
How claims adjusters compare
All occupations (923)
Business and financial operations (48)
Pay and outlook in the US
- Median pay
- $78,000 a year, May 2025
- People employed
- 324,230 in the US, May 2025
- Projected change in jobs
- -5.5% from 2024 to 2034
Skills to build
- Write property loss estimates in Xactware Xactimate
- Negotiate claim settlements live, in person or on Zoom
- Spot-check AI-entered payments and reserves in claim files
- Confer with legal counsel on litigated claim files
- Hold a state adjuster licence for your claim territory
Safer roles nearby
5 related occupations with lower scores.
Questions about claims adjusters and AI
Will AI replace claims adjusters?
Partly. About 5 in 10 working hours of a claims adjuster's time go to tasks AI can already do, mostly entering claim payments, reserves and new claims, and maintaining claim files. What stays with people is negotiating settlements, attending mediations and trials, and conferring with legal counsel on litigated claims.
Which claims adjuster tasks is AI taking over?
Entering payments, reserves and new claims into the claim system scores highest, at 82, because it is routine entry into fixed fields with short file notes. Maintaining claim files and inventories scores 78, since records upkeep is software work. Preparing reports for the data processing department scores 75, because structured output is generated directly from claims data.
Which claims adjuster tasks stay human?
Attending mediations or trials scores lowest, at 8, because it requires being physically present in the room. Negotiating claim settlements scores 22, since AI can model offer ranges but the live exchange stays with the adjuster. Resolving complex claims scores 25, because negotiation and service stay in the adjuster's hands while AI only prepares file summaries.
How do claims adjusters stay valuable?
Lead the live settlement conversation, since negotiation is the part AI leaves with you. Write and defend Xactware Xactimate estimates for property losses, because scope and pricing judgment sits with you. Spot-check AI-entered payments and reserves in the claim system before you sign off. Present your analysis at claim committee meetings, where presenting and debating stays human.
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