Insurance Claims Officer

Insurance Claims Officers are the people who sit between a policyholder and a payout. When someone makes a claim on their home, car, health, or business insurance, a claims officer reviews the paperwork, checks what the policy actually covers, contacts relevant parties such as repairers or medical providers, and works out what the insurer owes. The role is largely administrative and investigative. It requires careful reading, clear written communication, and the ability to handle people who are often stressed or upset. Some officers specialise in a single product line such as motor vehicle or workers compensation, while others handle a broader mix of claims.

A typical day involves opening new claims in a case management system, reviewing supporting documents such as police reports, invoices, or medical certificates, and contacting claimants or third parties to gather missing information. Officers write assessment notes, calculate settlement amounts within set guidelines, and refer complex or high-value cases to a senior assessor or loss adjuster. There is regular phone and email contact with customers, repairers, lawyers, and internal underwriting teams. Accurate record-keeping is central to the role because every decision needs a clear audit trail.

The minimum education level recorded for this occupation is Year 12 (JSA Occupation Profile). Many employers also look for a Certificate III or IV in Insurance, Financial Services, or Business Administration, which can be explored through yourcareer.gov.au. Some insurers provide in-house training for new claims staff. A background in customer service, administration, or a relevant technical field such as building, health, or law could support an application. Free TAFE options for related qualifications may be available in your state or territory at dewr.gov.au/skills-reform/free-tafe.

The hardest part of this role is managing the emotional weight of the work. Claimants are often dealing with a house fire, a serious accident, or a health crisis, and they may be frustrated, grieving, or angry when they call. Claims officers need to stay calm, follow process, and communicate decisions clearly even when those decisions are not what the customer hoped for. Fraud detection adds another layer of complexity, requiring officers to ask probing questions without alienating genuine claimants. The work can also be repetitive and target-driven, with case volume and turnaround times closely monitored. People who move into this role from customer service often find the technical side manageable but underestimate how much the emotional load builds over time.

Some roles, especially in workers compensation and motor claims, are spread across regional offices and contact centres in other states.

Published for ANZSCO unit group 5996, the wider group this job sits in, not for this job on its own.

This is the median for full-time employees who are not managers and are paid at the adult rate, before tax and salary sacrifice. It is a guide to what the work pays, not a wage rate.

Source: ABS Survey of Employee Earnings and Hours, May 2025, customised report.

See full salary breakdown by state

• Claims Assessor: what carries over
• Claims Triage Officer: what carries over
• Workers Compensation Claims Officer: what carries over

• Bank Teller to Insurance Claims Officer

• Attention to Detailcore
• Case Note Documentationcore
• Claims Processingcore
• Confidentiality and Privacy Compliancecore
• Data Entry and Accuracycore
• Eligibility Assessmentcore
• Policy and Procedure Adherencecore
• Problem Solvingcore
• Regulatory and Legislative Awarenesscore
• Risk Identificationcore
• Verification and Authenticationcore
• Written Communicationcore
• Active Listening
• Conflict Resolution
• Microsoft Office Suite Proficiency
• Quality Assurance and Checking
• Record Management
• Stakeholder Communication
• Time Management and Prioritisation

• ABS OSCA 2024, occupation definition and task statements
• ABS Survey of Employee Earnings and Hours, May 2025, customised report.

Role data is drawn from official Australian Government sources, and each figure names where it comes from. Where a role is not in the ABS classification, the page shows no government figures for it. Data may not reflect every local variation.

Where our numbers come from.

Last updated: 30 October 2026