Moving into claims from customer service: the first three moves

Start with what claims work actually is

A claims officer takes a claim from lodged to decided.

You collect the information. You check it against the policy. You ask for what is missing. You make or support a decision, and then you explain that decision to somebody who may be upset by it.

If you have spent years in customer service, you have done a version of this. The difference is that in claims the decision is yours to make or support, and it is written down.

Take the free three-minute Career Change Check at changingcareers.com.au/assessment if you have not yet. It is worth knowing your starting point.

Move one: work out which claims job you mean

"Claims" covers several jobs and people apply to the wrong one.

Claims officer or claims consultant. The usual entry point. Volume work, phone contact, straightforward decisions.

Claims assessor. More judgement, larger or more complex claims, less phone time.

Claims manager. Leads a team. Not a first move.

There are also specialisms: motor, home, life, income protection, workers compensation, and health. They are not interchangeable. The skills transfer between them, but the rules and the training do not.

Pick one lane before you start applying. A generic application to "claims" reads exactly like what it is.

Move two: turn your current work into claims language

This is where most applications fall over. Not on ability, on wording.

Insurers hire for a short list of things. Accuracy under volume. Following a process without needing to be watched. Explaining a bad outcome to someone without making it worse. Writing a clear note that a colleague can pick up cold.

You almost certainly do all four. Your resume probably does not say so.

So rewrite it in their terms. "Handled 60 calls a day" tells an insurer nothing. "Worked to a documented process, kept records that another officer could act on without asking me, and delivered decisions customers did not want to hear" tells them everything.

Do not invent anything. Just stop describing your job in call centre words when you are applying to an insurer.

Move three: check whether you need a qualification

Sometimes yes, often no.

Many entry level claims roles train you in house, because the rules change and they would rather teach you their way. Some specialisms expect a qualification first. Workers compensation and life insurance tend to be stricter.

The way to find out is not to ask us. Read six real ads in your state and see what they ask for. If most do not require a certificate, do not buy one yet.

If you do need training, check what is free before you pay. Start at dewr.gov.au/skills-reform/free-tafe. The official role description is on yourcareer.gov.au.

How to read your own fit

Take one real ad and be honest.

Most of it work you already do, in a different setting? Strong fit. Apply this week.

A system, a product type, or a short course between you and it? Good fit. Apply anyway, and start closing the gap.

A specialism that expects a qualification or industry background you do not have? Stretch fit. Worth a longer plan, not worth waiting for perfection.

Our claims pathway page lays out how these roles connect.

One honest warning

Claims is not automation proof. Simple, high volume, rules based claims are exactly the kind of work software handles well, and insurers have been working on this for years.

What is harder to automate is the contested claim, the unusual one, and the conversation with a person who has just been declined. If you move into claims, move towards that work rather than away from it. We wrote more on this in what survives in claims processing.

Frequently asked questions

Do I need an insurance qualification to get into claims?

Often not for entry level roles, because many insurers train in house. Some specialisms, particularly workers compensation and life insurance, tend to be stricter. Read six real ads in your state before you buy any course.

Which claims specialism is easiest to enter?

High volume general insurance lines such as motor and home tend to have the most entry level openings. That is also the work most exposed to automation, so treat it as a way in rather than a destination.

How do I describe call centre work on a claims application?

In their terms, not yours. Insurers hire for accuracy under volume, following a documented process, clear file notes, and delivering unwelcome decisions calmly. Say that you do those things, because you almost certainly do.

Is claims work at risk from AI?

Parts of it clearly are. Simple, rules based, high volume claims are the kind of work software handles well. Contested and unusual claims, and the conversations that follow a declined claim, are much harder to automate.

This is general information, not professional career, financial, or legal advice. For tailored advice, consult a qualified career counsellor, financial adviser, or relevant Australian professional service.