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Insurance Claims Handler Interview Questions

Position Summary

Insurance claims handlers ensure claims are processed efficiently and reimbursements are made for valid claims. They make the decision on whether a claim is valid or not by investigating for any fraudulent activity.

Another large part of an insurance claims handler’s job is to coordinate services. This includes ensuring the policyholder has filed their claim, coordinating services such as hiring tradespeople to make a home safe, or coordinating reimbursement for stolen items.

Responsibilities

Insurance claims handler responsibilities may include:

  • Investigating insurance claims 
  • Completing and filing correct claims documentation
  • Contacting tradespeople to carry out a claim
  • Liaising with law enforcement, lawyers, and professional investigators
  • Communicating with customers about their claims

Skills

Insurance claims handlers are responsible for making sure a customer’s claim is valid and fulfilled. In order to coordinate with the necessary parties, a skilled insurance claims handler will:

  • Communicate clearly with customers and other involved parties
  • Search proactively for proof that a claim is valid
  • Possess an eye for detail to ensure all forms are correctly filled out
  • Possess an expert knowledge of the insurance industry
  • Juggle several cases at a time

Qualifications

Employers typically require candidates to have an associate’s degree. The concentration of the degree is not necessarily important, although the more relevant it is to the industry you’re working in, the better. Additionally, candidates can seek out a bachelor’s degree to make themselves more appealing to employers.

If you’re getting ready to interview for a position as an insurance claims handler, you can prepare by researching the company as much as possible. Learn about the 9 things you should research before an interview.

Salary

Salaries for insurance claims handlers range between $41K and $61K with the median being $50K. 

Factors impacting the salary you receive as an insurance agent include:

  • Degrees (associate's, bachelor's)
  • Years of Experience
  • Location
  • Reporting Structure (seniority of the manager you report to, number of direct reports and office staff)
  • Level of Performance - Exceeding Expectations

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Insurance Claims Interview Questions

Question: What skills do you believe are required to be successful as an insurance claims handler?

Explanation: This is a general or opening question which the interviewer will ask you early in the interview to start the conversation, learn more about you, and gather the information they can use for subsequent questions.

Example: “Working as an insurance claim handler requires a broad range of skills. The most important of these skills is probably attention to detail. You also have to be methodical, a good communicator, a good observer, and possess a great deal of patience. The final skill I’ll mention is the ability to read people to determine if they are being truthful with you.”


Question: What are some of the typical questions you ask when investigating a claim?

Explanation: This is an operational question. The interviewer is trying to determine how you go about performing the duties of this job.  Operational questions are best answered directly with a brief description of the steps you take to accomplish the task about which they are asking.

Example: “Since every claim is different, the questions I ask are situational. However, some of the commons ones I would ask for an auto accident include:

  • Where did the accident occur (locations, intersection, type of road, etc.)?

  • How did the accident occur?

  • What did you see, hear, or otherwise observe?

  • How many vehicles besides yours were involved? Did you collect the other drivers' information?

  • Was anyone hurt? If so, who was hurt? What are their names and contact information?

  • Did anyone witness the accident? Did you get their names and contact information?

  • Did a police officer come to the scene? If so, from what agency? Do you have the officer’s name or badge number?

  • Do you have copies of any bills, receipts, or other paperwork related to the accident?”


Question: What was the most challenging claim in your career, and why?

Explanation: This is another operational question in which the interviewer is attempting to determine the scope of your experience. Your answer will indicate the type of claims you’ve handled as well as your ability to deal with stressful situations. Both of these points will provide the interviewer with a good idea of your qualifications.

Example: “The most difficult claim I have worked on appeared to be one of the easiest. Initially, everything fell into place with the information I collected, including witnesses, accident reports, medical records, etc. However, it just didn’t feel right to me. I continued to probe and expand the investigation. Just before paying out the claim, I discovered a piece of information that contradicted everything I had previously collected. I followed the lead and was able to determine that the claim was indeed fraudulent.”


Question: That’s very interesting. What will you do to make sure our company avoids similar fraudulent claims?

Explanation: This is a follow-up question to the previous one. Interviewers will ask follow-up questions if they are particularly interested in a topic or want some additional information about the answer you just provided them. You should anticipate follow-up questions any time you respond to an interviewer’s question.

Example: “Based on the experience I just related to you, the easiest way to prevent fraudulent claims is to continue to investigate even when you think you have all the answers. I make sure to double-check the information I already have and pull threads related to what I’ve learned to uncover additional details related to the claim. I also look into the archives for similar claims to see if I have missed anything.”


Question: Claims handlers spend much of their time on the phone. What communication skills do you possess that will help you be effective at this?

Explanation: This is yet another operational question, seeking to uncover your capabilities related to this position. The key to this type of question is to be brief and concise with your answer. Allow the interviewer to follow up if they need additional information.

Example: “Communicating on the phone is one of the more challenging aspects of this job. It requires good listening skills in addition to good communication skills. I prefer to use a headset when I’m on the phone in order to block out distractions in the office. I also use software to record the calls so I can review them at a later time. When speaking, I try to use a clear voice, speak slowly, and enunciate. I periodically ask the listener if they understand what I just told them.”


Question: As a claims handler, you are required to work with a variety of people, including agents, auto and home specialists, customers, and other adjusters in order to process claims. How do you make sure everyone is responsive to you?

Explanation: This question is meant to investigate your collaboration and communication skills. When answering, you should highlight these two skill sets, describing to the interviewer how you use them to accomplish your job.

Example: “When working with other stakeholders during the claim process, I strive to create a win-win situation. I first determine what the other person is trying to accomplish and align my goals with theirs. I am patient when working with them, but I’m also persistent. I will pursue an issue until I have the information I need or have accomplished the task necessary to process the claim.”


Question: How do you deal with a client who disagrees with your assessment of a claim?

Explanation: This is a behavioral question meant to discover how you will react to a specific situation. The best way to answer this type of question is by using the STAR framework. You first describe the Situation, then state the Task you need to accomplish, list the Actions you took, and finish with the Results you achieved.

Example: “Unhappy or dissatisfied clients are common in this business. When faced with this situation, the goal is to get the client to accept the claim assessment. I have found the best way to deal with these types of people is to stand firm on my assessment and state the rationale behind it. If I can’t convince them, I contact their agent and get them involved. Most of the time, this will resolve the situation. If it doesn’t, the case gets escalated to customer service specialists.”


Question: What information sources do you use to produce a report for a claim which requires an assessment of a house that was damaged in a fire?

Explanation: This is another operational question seeking to determine how you would handle a specific situation. In this case, the interviewer wants to understand the sources of information you use in your job. As a seasoned professional, you should be able to list several sources.

Example: “Assessing a home’s value after a fire is usually pretty straightforward. I start with county records which provide a great deal of information. I then look at appraisal reports for comparable properties in the area. The final information I use is the report filed by the homeowner. Together, these sources provide a comprehensive picture of the home’s value and the amount of the claim the company should agree to."


Question: Can you describe a situation where you missed some critical information in your appraisal and what you did to correct it?

Explanation: This is another behavioral question. You can recognize behavioral questions from phrases such as “describe a situation,” or “can you tell me about a time.” When you hear this, you should identify the question as behavioral and use the STAR framework for your answer.

Example: “It doesn’t occur often, but I have had situations where I’ve missed critical information when processing a claim. The last time this happened involved an auto accident claim I worked on. The missing information entailed some contents of the vehicle that were part of the loss. When I discovered the error, I notified the company, the agent, and my manager. I reassessed the situation and submitted an amended claim report. This was accepted by both the company and the claimant.”


Question: Can you describe some creative approaches you have taken when inspecting a complicated claim? 

Explanation: An interviewer will ask this type of question to gain some understanding of your creativity and ability to think on your feet.  This is important for an insurance claim handler who may encounter a variety of different situations in the course of their work. You should try to think of realistic and interesting techniques you use which will differentiate you from the other candidates.

Example: “Since no two claims are alike, I often have to come up with innovative ways to collect information I need to process a claim.  Some of these have included using a drone to inspect a property after a fire, spending some time observing an intersection in which an accident occurred, using social media to investigate a claimant’s background, and posing as a newspaper reporter to interview prospective witnesses to an accident.”


Additional Insurance Claims Interview Questions

  • Tell me about a claim in which you were unable to satisfy a customer’s needs. What was the situation and the outcome?

  • Would you disregard a company policy to satisfy a customer?

  • How would you tell a customer that their claim had been denied?

  • You will be handling multiple cases at the same time. What systems do you use to stay organized?

  • Name a time you had to advise all parties of a shared liability and explain the final decision.

A word of warning when using question lists.

Question lists offer a convenient way to start practicing for your interview. Unfortunately, they do little to recreate actual interview pressure. In a real interview you’ll never know what’s coming, and that’s what makes interviews so stressful.

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