目錄
簡介 Intro
保險理算員調查保險索賠和確定保單所涵蓋的損失或損害的數額。他們受僱於保險公司的理賠部門，或作為獨立的理算員。保險索賠審查員檢查由保險理算員調查過的索賠，並授權付款。他們受僱於保險公司的總部或分支機構。
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.
完成加拿大保險協會的教育計劃，或其省級同行賦予保險理算員和索賠審查員作為特許保險專業（CIP）的專業人士，作為特許保險專業研究員（FCIP），還需要學習更多的其他大學課程。
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).
主要職責 Main Duties
保險理算員執行部分或全部下列職責：Insurance adjusters perform some or all of the following duties:
- 調查保險理賠的情況，確定索賠的有效性
- Investigate circumstances surrounding insurance claims to determine validity of claim
- 檢查汽車，家庭或其他財產損失
- Inspect automobile, home or other property damage
- 錄取口，諮詢索賠者，事故目擊者，醫生和其他有關人士，檢查記錄或報告
- Take statements and consult with claimants, accident witnesses, doctors and other relevant individuals and examine records or reports
- 確定保單所涵蓋的損失或損害賠償金額
- Determine amount of loss or damages covered by insurance policies
- 協商解決索賠
- Negotiate settlement of claims
- 準備理算報告。
- Prepare adjustment reports.
保險索賠檢查員執行部分或全部下列職責：Insurance claims examiners perform some or all of the following duties:
- 審查，檢查，計算，並授權由保險理算員調查的保險索賠
- Review, examine, calculate and authorize insurance claims investigated by insurance adjusters
- 檢查理算員的報告和類似的保險索賠或先例，以確定保險保障程度
- Examine adjusters’ reports and similar insurance claims or precedents to determine extent of insurance coverage
- 確保索賠的有效性，按照公司常規及程序進行結算
- Ensure claims are valid and settlements are made according to company practices and procedures
- 諮詢律師，醫生或其他有關人士，討論保險理賠
- Consult lawyers, doctors or other relevant individuals to discuss insurance claims
- 批准汽車，消防，生活，殘疾，牙科或其他保險索賠。
- Approve automobile, fire, life, disability, dental or other insurance claims.
任職要求 Employment Requirements
- 必需完成中學學業。
- Completion of secondary school is required.
- 大學本科學歷，大專以上文憑或中學後教育
- A bachelor’s degree, college diploma or some post-secondary education
- 或多年的理賠部門業務員經驗，或其他一般保險經驗。
- Several years of experience as a clerk in the claims department or other general insurance experience are required.
- 必需具備多年的在職培訓以及保險業課程和培訓計劃。
- Several years of on-the-job training and completion of insurance industry courses and training programs are required.
- 獨立理算員要求具備由就業省份或地區保險監督官頒發的省級許可證。
- Independent adjusters require a provincial licence issued by the Superintendent of Insurance in the province or territory of employment.
所有職稱 All Titles
- 理算員 adjuster
- 理算員 – 保險 adjuster – insurance
- 見習理算員 – 保險 adjuster trainee – insurance
- 汽車索賠技術理算員 automobile claims technical adjuster
- 意外傷害保險理算員 casualty insurance adjuster
- 理賠 – 保險 claims adjuster – insurance
- 索賠審批 – 保險 claims approver – insurance
- 理賠顧問 claims consultant
- 索賠審查員 claims examiner
- 索賠審查員 – 保險 claims examiner – insurance
- 理賠調查員 claims investigator
- 理賠調查員 – 保險 claims investigator – insurance
- 聲稱代表 claims representative
- 聲稱代表 – 保險 claims representative – insurance
- 傷殘索賠檢查員 – 保險 disability claims examiner – insurance
- 救災理賠 – 保險 disaster relief claims adjuster – insurance
- 現場理算員 – 保險 field adjuster – insurance
- 火災保險公估 fire insurance adjuster
- 貨運理算員 – 保險 freight adjuster – insurance
- 團體壽險索賠審查員 – 保險 group life claims examiner – insurance
- 健康和牙科的索賠審查員 – 保險 health and dental claims examiner – insurance
- 保險理算員 insurance adjuster
- 保險巡視員 insurance inspector
- 負債理算員 – 保險 liability adjuster – insurance
- 損失檢查員 – 保險 loss examiner – insurance
- 海洋理賠員 – 保險 marine claims adjuster – insurance
- 船舶保險公估 marine insurance adjuster
- 醫療估損 – 保險 medical claims assessor – insurance
- 機動車輛理賠 – 保險 motor vehicle claims adjuster – insurance
- 產品檢查員 production examiner
- 物業理算員 – 保險 property adjuster – insurance
- 公共理算員 – 保險 public adjuster – insurance
- 鐵路理賠員 – 保險 railroad claims adjuster – insurance
- 結算管理聯營公司 settlement management associate
- 結算專家 settlement specialist
- 人員理算員 – 保險 staff adjuster – insurance
- 電話理算員 – 保險 telephone adjuster – insurance
- 見習理算員 – 保險 trainee adjuster – insurance
- 工人補償理算員 – 保險 workers’ compensation adjuster – insurance
不包括職稱 Exclusions
- 主管，金融和保險工作人員 Supervisors, finance and insurance office workers 1212