Insurance

The insurance industry is divided into three main branches: life insurance, health insurance, and property and casualty insurance. Companies may specialize in one or all three types of coverage.

Life Insurance

Life insurance is basically a means by which one person provides for the financial security of others, usually other family members, in the event of that person’s death. Using life insurance in its simplest form, a person pays an insurance company a small amount on a regular basis (monthly, semiannually, annually) for a policy that guarantees that the family will receive a relatively large amount of money if the person dies while covered by the policy. However, many life insurance policies combine this form of protection with others. Some provide for the policyholder to receive a regular income after reaching retirement age. Some provide funds for a college education for the policyholder’s children. Some will pay off the mortgage on a person’s home if he or she dies or becomes unable to work.

Many life insurance companies now offer critical care insurance. This insurance helps defray the costs of treatment for cancer and other critical illnesses. With medical advances and more patients surviving years with critical illnesses, this insurance provides benefits for patients and their families while the insured is still alive instead of only providing for the family upon the death of the insured.

Health Insurance

Health insurance pays all or part of hospitalization, surgery, medicine, and other medical costs. This helps protect the policyholder against large medical bills in the case of an illness or accident.

In Canada and other countries, people are covered by government health insurance. In the United States, health insurance is usually provided by insurance companies or managed care plans, which include health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Usually, an employer pays part of the insurance premiums for employees. The government helps defray medical costs for the elderly and disabled through the Medicare program and for the poor through Medicaid. Supplemental medical insurance is often purchased to cover some costs not covered by Medicare.

Property and Casualty Insurance

Property and casualty insurance comes in a wide variety of forms. It includes the different kinds of insurance that protect people from financial loss if their property is destroyed, damaged, or stolen. It also includes all forms of liability insurance, the insurance that protects people from financial loss if they are responsible for injury to another person or damage to another person’s property. An example of liability insurance is medical malpractice insurance.

Within the property and casualty field, there are several specialized branches, or lines, of insurance. Some companies write all lines, while others write only one. In addition to insurance on homes, business places, automobiles, and personal property, this field includes marine insurance, which covers boats and ships and their cargoes, and inland marine insurance, which covers almost anything capable of being transported or which is used in transportation. Inland marine insurance covers everything from furs and paintings to locomotives and bridges.

Also included in the property and casualty field is worker’s compensation insurance, which pays a person for loss of wages and medical expenses if he or she is disabled because of an injury or illness connected with a job. Worker’s compensation also provides death benefits for dependents if death is due to a work-connected injury or illness. Fidelity bonds, which protect an employer from loss due to dishonesty of an employee, and surety bonds, which guarantee that contracts will be carried out properly, are other forms of insurance written by property and liability companies.

Since the insurance industry is all about managing risk, the focus for most people who work in industry-specific jobs is examining and reducing risk for both the company and the customer. Even salespeople, whose goal is to sell insurance policies, know that they must assess the risk associated with each client and recommend a product that fits the client’s needs, and still protects the insurance company from unnecessary risks. Claims processors, adjusters, and examiners also do their part to ensure that the claim is legitimate and meets policy requirements. Managers monitor the flow of work to make sure that claims are processed accurately and in a timely manner and underwriters ensure that policies are falling into acceptable, defined risk guidelines.

Actuary

The goal of the actuary is to look at the latest trends and statistics of a specific occurrence, whether it is fire, theft, death, illness, a car accident, etc., and use this information to construct probability tables to forecast risk and future claims owed. The life and health insurance actuary studies the current mortality, accident, sickness, disability, and retirement rates in order to develop this information. The property and casualty actuary considers past fire, accident, and lawsuit activity levels and trends them into the future based on history and judgment.

Some actuaries also make recommendations for policy premiums as well as the cash reserves the company needs to maintain in order to ensure that claims can be paid. Actuaries work in a variety of roles throughout an insurance company including pricing, product development, underwriting, investments, reserving, and claims.

Some actuaries work as consultants. The majority of actuaries usually work a regular business day and week, but some may have to travel to meet with other departments of the company, or with other businesses. Working conditions are usually good; actuaries work in an office, which are temperature controlled and comfortable. Actuaries enjoy solving problems through data analysis and modeling and are energized by working with algorithms, computers, and emerging technology such as artificial intelligence.

Appraiser

Insurance appraisers work primarily in the auto insurance sector or other property insurance sectors. They appraise the damage to all types of property including cars, boats, businesses, and homes. The appraiser must stay up to date on the value of automobiles and their replacement parts and repairs. He or she is asked to appraise the damage to a vehicle and make sure that repair estimates are in line with his or her appraisal, or if the vehicle is a total loss then the appraiser determines the salvage value of the vehicle. Appraisers also prepare the insurance reports and forms and make recommendations regarding claim settlement amounts. Appraisers are often out in the field inspecting vehicles or homes, which means they may need to crawl on the ground, climb ladders, or work in adverse weather conditions. Once inspections are complete, the rest of their work is completed inside, in an office atmosphere. Appraisers may have to work evenings or weekends to meet with customers, and the clients can be stressed and unhappy, which can make the appraiser’s job more difficult.

Auditor

Auditors are commonly seen in most financial institutions, including insurance companies that are required to meet state regulations (and some federal regulations). Auditors frequently handle confidential client information and large sums of money in transactions. Auditors review the operations of all departments and make recommendations for increasing company and client security and the company’s compliance with regulations. This information can include accounting procedures, banking procedures, tax filings, customer transactions, and investment decisions and processes. Like most workers in the insurance industry, auditors typically work during regular business hours in a comfortable, indoor environment. Some auditors may work evenings when the department is closed so they do not interrupt normal operations. Also, some auditors may have to travel to branches of the company in other states or cities to perform their audits. Some consider the auditor’s job stressful, because those being audited may find the process intrusive and the resulting recommendations difficult to implement. That said, audits provide valuable information to management to ensure continuous operational improvement and more efficient processes.

Broker

Insurance brokers do not work for one company. Instead, they represent the buyers, and work with several different insurance companies to provide their buyers with the best coverage at the lowest cost. Most brokers cultivate relationships with several insurance companies that they use on a regular basis. Brokers need a high level of knowledge since they work with complex business risks.

Brokers do the shopping for the buyer, getting quotes from the companies they work with, and presenting the best quote to the client. A broker’s schedule depends on how well his or her business is going. Most brokers can do business in a normal workday and during the week, but some may meet with clients during the evening or on weekends, or need to extend their hours to meet their clients’ needs. Brokers also attend networking events and meeting so that they are constantly increasing their visibility and potential client base. Most of the time brokers work in a comfortable, indoor environment.

Claims Adjuster

Claims adjusters must achieve a difficult balance between delivering the promise of payment made by the policy and managing customers' expectations. For example, the current value of a car totaled in an accident is frequently below that expected by the policyholder, but coverage is only available for the documented value of the vehicle as it was prior to the accident. When there is an at-fault claim, the claims adjuster determines what injuries or damages are a result of the accident versus those that were pre-existing. For example, if another vehicle is involved in the accident and hit the covered vehicle on the front passenger side of the car, the policy will not cover damage to the vehicle in other locations.

The adjuster is called in to negotiate payment amounts of insurance claims. For example, in an auto accident, if someone was injured and the client was at fault, the insurance company negotiates how much of the medical expenses the insurance company will cover. Sometimes claims adjusters provide information that is used in a court case or they refer questionable claims to an investigator. Most claims adjusters are able to work a regular 40-hour workweek schedule, during normal business hours. Some adjusters may have to make field visits or on-site inspections. When a catastrophe occurs, such as a tornado or hurricane, claims adjusters work long hours, frequently away from home, to assist local policyholders.

Claims Examiner

Claims examiners perform work very similar to that of adjusters. Examiners look at insurance claims and perform their own investigations to ensure that they are legitimate. If a claim seems out of line or questionable, the examiner will refer it to an investigator. Examiners may also provide recommendations and information for court cases or insurance disputes. Like adjusters, most examiners work in an office. However, they may have to travel to other locations for on-site inspections or to assess damage or other conditions firsthand. Most of the time they are able to work during normal business hours.

Claims Investigator

The claims investigator handles claims that adjustors or examiners have called into question. In these cases, the adjuster or examiner suspects that there may be fraud involved, either on the part of the claimant, another person involved, or the company involved in the repairs to the vehicle, home, or other item of property that’s been damaged. The investigator interviews everyone involved in the claim and determines if there is anything fraudulent going on. If so, the company may choose to pursue legal action. Claims investigators typically work a regular 40-hour week, although they may be required to work evenings or an occasional weekend in order to meet with people involved in a claim. The investigator’s job can be stressful and sometimes even dangerous, when criminal activity is involved.

Claims Processor

Claims processors are usually the first people in the company to handle a claim. Their primary job is to log reports into the claims system, record all information regarding the claim, make sure all the required information has been entered, and then pass the report to the next step in the process, usually an adjuster or examiner. Claims processors may call the policyholder to clarify information or get information that is missing. They may be required to accurately process many claims a day. In general, claims processors work 40 hours per week. However, there are usually several shifts, since most companies offer 24/7 claims reporting. Some processors may be required to work later in the day or during the evening. Some processors may be required to work on Saturdays or Sundays. However, all processors work in an office environment, under comfortable working conditions.

Customer Service Representative

In the insurance industry, customer service workers answer customers’ phone calls regarding the business administration of their policies, primarily billing questions or issues. Although many companies provide information online, customers still have questions that customer service reps need to answer. The reps interact with customers on the phone, and with some companies, also online. They are trained to find information on the company’s customer service system. Customer service reps can work several different shifts, including evenings and weekends, to provide service to customers who are unable to call during the workday. The environment can be fast-paced and stressful, but the working environment is usually pleasant.

Manager/Executive

Managers and executives are responsible for the day-to-day operations of the insurance company as well as its overall direction and performance. They make sure company financial and customer service goals are met, and that employees have what they need to perform their jobs. Typically, higher-level managers and top-level executives experience more job stress and pressure, since they are accountable if something goes wrong. It can also be a tough balancing act when the executive must keep the company’s primary constituents happy: regulators, shareholders, customers, and employees. Managers and executives can work longer hours than other employees, but usually they work during normal business hours. Often managers and executives will have to travel to meet with customers or other stakeholders.

Personal Financial Advisor

Financial advisors are trained to work with customers to provide them with expert financial information and advice. Often they put together a complete package of services for the customer that includes investment products, retirement investment products, and insurance products. Personal financial advisors must be licensed and certified. Advisors that work for insurance companies receive their clients through other department’s referrals. Other advisors must market their services like brokers do. Personal financial advisors often have to meet with clients after hours, when the clients aren’t working. They usually don’t work more than 40 hours per week, but the 40 hours can include evenings. They usually don’t travel outside of their own local area.

Sales Agent

Insurance salespeople usually either work for a brokerage firm, an insurance agency, or independently on their own. Captive insurance agents are those that work for an agency that represents a specific insurance company, selling only that company's products to their clients, while independent insurance agents sell policies from several different insurance carriers. Brokers offer commercial lines of insurance to businesses. Most large companies have sales agents in the larger cities, and although the company may help with the marketing and advertising, the agents are largely responsible for drumming up business and maintaining a steady flow of new clients. Sales agents may find themselves working a variety of hours, from breakfast meetings to evening seminars and networking events. Some also meet with clients on weekends when necessary. Most sales agents do not travel outside of their area of responsibility, except for training or national sales meetings. Work is usually completed in a comfortable office environment.

Underwriter

Underwriters perform a critical job in the insurance industry. They look at client applications for insurance and decide whether they are an acceptable risk to the company given the pricing assumptions made by the actuaries. Underwriters work in nearly all sectors of the industry. For example, in the auto industry, they look at an applicant’s driving record for excessive violations or problems. They also look at the applicant’s age, job, married status, and other indicators of his or her stability and risk. If the applicant falls within acceptable underwriting standards, his or her application is accepted and he or she is granted the policy. At some large companies, underwriters may be required to work evenings and Saturdays in order to move applications through the underwriting process as quickly as possible. Most work is completed in an office environment, and travel is occasionally required for training and conferences.