Are you an analyst who works in insurance claims processing? If so, you may be entitled to overtime pay under the Fair Labor Standards Act (FLSA). Many companies have classified salaried claims analysts as exempt from overtime pay, but with the increasing use of technology and processing software, analysts are often performing more clerical tasks that do not require independent judgment or discretion. This means they may no longer qualify as “administrative professionals” under the FLSA and may be eligible for overtime pay.
Courts that have dealt with this issue will find the DOL’s guidance (Fact Sheet #17L: Insurance Claims Adjusters) helpful.
Insurance claims adjusters play a vital role in the insurance industry. They investigate and evaluate insurance claims, determining the validity of a claim and the amount of compensation that should be awarded. Claims adjusters may work for insurance companies or as independent contractors, and they may specialize in a particular type of insurance, such as auto or property insurance.
To qualify for the administrative employee exemption, claims adjusters must meet certain criteria set by the U.S. Department of Labor. This includes being compensated on a salary or fee basis at a rate of at least $684 per week, and performing duties that are directly related to the management or general business operations of the employer or the employer’s customers. Claims adjusters must also exercise discretion and independent judgment with respect to matters of significance.
The duties of a claims adjuster typically include interviewing insureds, witnesses, and medical professionals; inspecting property damage; reviewing factual information to prepare damage estimates; evaluating and recommending coverage for claims; determining the liability and total value of a claim; negotiating settlements; and making recommendations regarding litigation. Why does this sound familiar? It’s describing insurance adjusters for car accidents and injury claims where injured third parties are suing the insured. This is what we buy insurance for our cars, homes, and businesses. The last few duties and activities described by the DOL are key because many claims analyst process short term and long term disability insurance benefits without doing any negotiation of settlement or make recommendation for litigation.
If you believe you fall into this category, it’s important to speak with an attorney about your rights. Federal law prohibits employers from retaliating against employees who exercise their legal rights or report potential labor law violations, so you can feel confident in seeking the overtime pay you deserve. Our firm is currently investigating potential overtime violations at a number of companies, including Altruis, American National, Chubb, Dearborn, Erie, Farmers Insurance, Federated Mutual, General Casualty, Grange Insurance, Hartford Fire Insurance Company, Horace Mann, Indiana Farm Bureau, Kemper Corporation, Liberty Mutual, MetLife, MetLife Home & Auto, Motorist Mutual, Nationwide Insurance, Ohio Casualty, Oracle, Pekin Insurance, QBE, Royal, Saint Paul, Sedgwick, State Auto, Travelers, Twenty-First Century, Unitrin, USAA, Utica Mutual, Wausau, Westfield Group, Zurichh
If you’ve worked for any of these companies or believe your job duties and responsibilities are similar to those described above, please don’t hesitate to contact us to learn more about your potential overtime claim. The look back period for overtime violations is ongoing, so if you think you have a claim contact us.