Life Insurance Examiner: Steps To Start Your Career

A life insurance examiner reviews the causes of death, paying particular attention to accidents, as most life insurance companies pay additional benefits for accidental deaths. They also review new life insurance policy applications to ensure that applicants have no serious illnesses that would make them high-risk. Life insurance examiners are responsible for evaluating and processing claims, deciding whether to authorise or deny payments, and referring suspicious or complicated claims to insurance investigators. While some employers require a bachelor's degree, many entry-level positions only require a high school diploma and provide on-the-job training. Licensing requirements vary by state, with some requiring a licensing exam.

Entry requirements: A high school diploma or bachelor's degree

To become a life insurance examiner, you will typically need a high school diploma or a bachelor's degree. Some employers may require a bachelor's degree, but many entry-level positions only ask for a high school diploma and provide on-the-job training.

Having a bachelor's degree in a related field or equivalent experience is often preferred by employers. Relevant degrees include subjects such as health administration, finance, or a similar field. This level of education provides a good foundation for the role, as it demonstrates a strong understanding of the industry and the ability to handle complex information.

However, a high school diploma is generally the minimum requirement for entry-level positions. This basic requirement ensures that candidates have the necessary critical thinking and communication skills to perform the duties of a life insurance examiner. Obtaining a high school diploma or equivalent qualification is the first step towards a career in this field.

In addition to a high school diploma, some insurance companies may also require previous work experience in a related field. This could include experience in customer service, insurance, or claims handling. Having this practical experience can be valuable, as it demonstrates an understanding of the insurance industry and the ability to apply knowledge in a real-world context.

While a bachelor's degree is not always necessary, it can certainly enhance your qualifications and make you a more competitive candidate for life insurance examiner positions. It is important to check the specific requirements of the employer and the state in which you intend to work, as they may vary.

On-the-job training: Working on small claims under supervision

On-the-job training is a crucial aspect of becoming a life insurance examiner, and it begins with working on small claims under the supervision of an experienced examiner. This phase of training provides new examiners with the opportunity to apply their knowledge and skills to real-world scenarios while receiving guidance and feedback. Here are some details about what to expect during on-the-job training as a life insurance examiner:

Gaining Practical Experience:

Under the mentorship of a seasoned examiner, new examiners tackle small claims to gain practical experience. They review claim files submitted by insurance adjusters, analyzing the circumstances surrounding each claim. This includes assessing the cause of death in life insurance claims, with a particular focus on accidents, as most life insurance companies offer additional benefits for accidental deaths. By starting with smaller claims, new examiners can develop their analytical skills and understanding of the claims process without being overwhelmed.

Decision-Making and Authorization:

During on-the-job training, new examiners learn how to make informed decisions on claim authorization. They determine whether to authorize or deny payments, ensuring compliance with company guidelines and state regulations. This decision-making process involves scrutinizing medical documentation and records to assess the accuracy and validity of claims. It also entails identifying potential fraud and referring suspicious or complicated claims to insurance investigators when necessary.

Communication and Collaboration:

On-the-job training emphasizes the importance of effective communication and collaboration. New examiners interact with customers, claimants, and other departments to gather information, clarify details, and ensure timely and accurate claims processing. They develop skills in active listening, clear explanations of claim decisions, and maintaining confidentiality. Additionally, they learn to work as part of a team, coordinating with colleagues to resolve claims efficiently and fairly.

Regulatory and Compliance Knowledge:

Life insurance examiners must have a solid understanding of state and federal regulations pertaining to insurance and claims processing. On-the-job training helps new examiners navigate the complex landscape of compliance by providing hands-on experience in applying these regulations to real-world scenarios. They learn about licensing requirements, which vary by state, and may include prelicensing education or passing a licensing exam. This aspect of training ensures that new examiners can make informed decisions while adhering to legal and ethical standards.

Continuous Learning and Development:

On-the-job training is a continuous process where new examiners gradually take on more complex claims as their knowledge and skills progress. As they gain proficiency in handling small claims, they receive feedback and guidance from their supervisors, identifying areas for improvement and refining their decision-making abilities. This continuous learning environment allows new examiners to build their expertise and confidence in handling more challenging cases independently.

On-the-job training for life insurance examiners working on small claims under supervision is a comprehensive and supervised process that equips new examiners with the practical skills and knowledge necessary to excel in their roles. It provides a strong foundation for a career in life insurance examination, fostering the development of analytical thinking, decision-making, and communication skills within the framework of regulatory compliance.

Exams: A licensing exam is required in some states

To become a life insurance examiner, you will need to pass a licensing exam in some states. The requirements for these exams vary, so it is important to check the specific regulations in your state. Generally, you will be tested on topics such as HMOs, health insurance tax issues, annuities, and life insurance plans. Some states' tests contain 150 questions, while others have only 50. The time limit for the exam can also differ, ranging from 1.5 to 2.5 hours.

On the day of the exam, you will need to present a government-issued photo ID, and you may be required to show your test confirmation. No electronics or valuable items are allowed in the testing center. In terms of preparation, it is recommended that you take practice tests to identify areas where you need to improve. Memorizing questions and answers is not a good strategy, as exams often cover different topics. Instead, focus on understanding the underlying concepts.

Additionally, some states have other requirements, such as a background and fingerprint check. It is important to familiarize yourself with the specific requirements of your state to ensure you are fully prepared for the licensing exam.

Career progression: You'll be assigned more complex claims as you gain experience

As a life insurance examiner, you will start by working on small claims under the supervision of an experienced worker. As you gain experience, you will be assigned more complex claims. This progression allows you to develop your skills in claims investigation and settlement. Here are some details on what to expect as you advance in your career:

At the beginning of your career, you will be guided by a mentor who will help you navigate the intricacies of the job. You will learn the ropes of reviewing claims, ensuring compliance with guidelines, and making decisions on authorization or denial of payments. This foundational knowledge will serve as a solid base for your future growth.

As you gain experience, the complexity of the claims you handle will increase. You will be trusted to handle larger, more complex claims and navigate more challenging situations. This progression will test your analytical skills and your ability to make informed decisions. It is important to stay up to date with industry regulations and continue developing your expertise in insurance policies.

With time, you will become a go-to person for complex claims. Your organization and communication skills will be crucial in managing these intricate cases. You will collaborate closely with policyholders, adjusters, lawyers, and medical professionals to gather the necessary information and make informed decisions. Your investigative skills will be honed as you review police reports, medical records, and other relevant documentation.

As a senior examiner, you will be expected to mentor and guide junior examiners. Sharing your knowledge and expertise will be an important aspect of your role. You will also be involved in identifying process improvements and contributing to the overall efficiency of the claims handling process. Your experience will be invaluable in streamlining procedures and enhancing the overall customer experience.

Throughout your career, you will encounter a diverse range of claims, each presenting unique challenges and complexities. Your ability to adapt, learn, and make judicious decisions will be key to your success. Remember, each claim you handle has a significant impact on people's lives, so a compassionate and meticulous approach is essential.

Skills: Analytical and communication skills are key

Analytical and communication skills are key to becoming a life insurance examiner. Examiners need to be able to evaluate complex information and make decisions based on their analysis. They must also effectively communicate their findings and decisions to policyholders, adjusters, lawyers, and medical professionals.

Analytical skills are essential for reviewing and evaluating insurance claims. Examiners need to be able to assess the validity of a claim, determine the appropriate level of compensation, and identify potential fraud or suspicious activity. This requires a detailed understanding of insurance policies, regulations, and industry standards. For instance, examiners need to be able to review medical documentation and records to ensure accuracy and compliance with state and federal regulations. They also need to be able to identify and investigate questionable claims, reviewing police reports and medical records to assess damage and loss.

Communication skills are vital for interacting with various stakeholders throughout the claims process. Examiners must be able to communicate effectively with policyholders, providing clear and concise information about their claims. They also need to collaborate with adjusters, lawyers, and medical professionals to gather information, resolve disputes, and make informed decisions. Strong communication skills enable examiners to build trust, explain complex information, and handle sensitive situations with empathy and professionalism.

In addition to analytical and communication skills, life insurance examiners should possess strong attention to detail, knowledge of medical terminology, and excellent interpersonal skills. They should be able to organize and prioritize their work, manage multiple tasks, and make timely decisions. Problem-solving, negotiation, and investigative skills are also valuable for handling complex claims and reaching fair resolutions.

To develop these skills, aspiring life insurance examiners can pursue a bachelor's degree in a related field, gain industry experience, and consider obtaining relevant certifications such as the Associate in General Insurance (AINS) or Certified Insurance Examiner (CIE) designation. Entry-level positions often provide on-the-job training, allowing individuals to develop their analytical and communication skills further and build a strong foundation for a successful career in life insurance examination.

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