加拿大联邦技术移民：NOC 1233 保险理算员及理赔审核员 Insurance Adjusters and Claims Examiners

1233 加拿大保险理算员及理赔审核员职责概述 

保险理算员主要负责调查保险索赔，并确定在保单承担范围内的损失数额。他们受雇于保险公司的理赔部门，或者担任独立的理赔员。保险理赔审核员负责核查理算员调查研究的索赔数额并执行赔偿支付。他们受雇于保险公司的总公司或者分公司。 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.

1233 加拿大保险理赔员及理赔审核员头衔范例 Example Titles

• 理赔员 adjuster

• 理赔审核员 claims examiner

• 索赔代表 claims representative

• 保险理算员 insurance adjuster

1233 加拿大保险理算员及理赔审核员主要职责 Main duties

A 保险理算员主要履行以下部分或者全部职责： Insurance adjusters perform some or all of the following duties:

• 调查保险索赔的情况以确定索赔的有效性 Investigate circumstances surrounding insurance claims to determine validity of claim

• 检查汽车、住宅及其它财产的损失 Inspect automobile, home or other property damage

• 发表声明，与索赔人、事故目击者、医生和其它有关人员协商并彻查报告和记录 Take statements and consult with claimants, accident witnesses, doctors and other relevant individuals and examine records or reports

• 确定保单范围内的损失 Determine amount of loss or damages covered by insurance policies

• 协商解决索赔 Negotiate settlement of claims

• 准备赔偿报告 Prepare adjustment reports.

B 保险理赔审核员主要履行以下部分或者全部职责： Insurance claims examiners perform some or all of the following duties:

• 评审、检查、计算并执行保险理算员调查研究的理赔数额 Review, examine, calculate and authorize insurance claims investigated by insurance adjusters

• 核查理算员的报告以及相似的保险索赔先例，以确定保险责任范围 Examine adjusters’ reports and similar insurance claims or precedents to determine extent of insurance coverage

• 确保理赔的合理性，并制定符合公司规定的理赔诉讼手续 Ensure claims are valid and settlements are made according to company practices and procedures

• 向律师、医生以及其它相关人员咨询请教，商讨理赔事宜 Consult lawyers, doctors or other relevant individuals to discuss insurance claims

• 为汽车、火灾、人身、伤残、牙齿以及其它保险理赔提供证据 Approve automobile, fire, life, disability, dental or other insurance claims.

1233 加拿大保险理算员及理赔审核员就业要求 Employment requirements 

• 要求有高中学学历 Completion of secondary school is required.

• 要求学士学位、大学文凭或者大专教育，或者有多年理赔部门文员或一般保险工作的工作经验 A bachelor’s degree, college diploma or some post-secondary education or Several years of experience as a clerk in the claims department or other general insurance experience are required.

• 要求有多年在职培训的经历并且完成保险业课程和培训计划 Several years of on-the-job training and completion of insurance industry courses and training programs are required.

• 独立的理算员需要由省级保险机关颁或雇佣单位颁发省级执照 Independent adjusters require a provincial licence issued by the Superintendent of Insurance in the province or territory of employment.

1233 加拿大保险理算员及理赔审核员附加信息 Additional information

• 完成加拿大保险协会或者省级机构的教育规划后，保险理算员和理赔审核员将得到职业认可，并成为受特许的保险专业人员（CIP），接受了附加大学课程教育的称为资深保险专业人员 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).

1233 加拿大保险理算员及理赔审核员其它分类 Classified elsewhere

• 金融及保险职员主管（见1212）Supervisors, Finance and Insurance Clerks (1212)

1233 加拿大保险理算员及理赔审核员所有头衔 All titles

• 保险理算员 adjuster – insurance

• 保险理算培训生 adjuster trainee – insurance

• 汽车索赔理赔理算员 automobile claims technical adjuster

• 意外保险理算员 casualty insurance adjuster

• 索赔理算员—保险 claims adjuster – insurance

• 索赔审批员—保险 claims approver – insurance

• 索赔顾问 claims consultant

• 索赔审查员—保险 claims examiner – insurance

• 理赔调查员 claims investigator

• 理赔调查员—保险 claims investigator – insurance

• 索赔代表 claims representative

• 索赔代表—保险 claims representative – insurance

• 伤残索赔审查员—保险 disability claims examiner – insurance

• 救灾理赔索赔理算员—保险 disaster relief claims adjuster – insurance

• 区域理算员—保险 field adjuster – insurance

• 火灾保险理算员 fire insurance adjuster

• 货运理算员-保险 freight adjuster – insurance

• 团体人寿索赔审查员-保险 group life claims examiner – insurance

• 口腔保健索赔审查员-保险 health and dental claims examiner – insurance

• 保险理算员 insurance adjuster

• 保险监督员 insurance inspector

• 责任理算员-保险 liability adjuster – insurance

• 亏损审查员-保险 loss examiner – insurance

• 海洋索赔理算员-保险 marine claims adjuster – insurance

• 海洋索赔理算员 marine insurance adjuster

• 医疗索赔评估员-保险 medical claims assessor – insurance

• 机动车辆索赔理算员-保险 motor vehicle claims adjuster – insurance

• 生产审核员 production examiner

• 财产理算员-保险 property adjuster – insurance

• 公共理算员-保险 public adjuster – insurance

• 铁路索赔理算员-保险 railroad claims adjuster – insurance

• 结算管理人员 settlement management associate

• 结算专员 settlement specialist

• 人员理算员-保险 staff adjuster – insurance

• 电话理算员-保险 telephone adjuster – insurance

• 培训生理算员-保险 trainee adjuster – insurance

• 工人补偿理算员-保险 workers’ compensation adjuster – insurance