This training program provides participants with knowledge and skills related to the insurance claims department and its functions, claims philosophy, various types of reserves, as well as a review of methods for combating fraud in insurance claims, unwarranted overpayments of claims amounts, estimating the claims provision, as well as describing the role of reinsurance in managing catastrophic claims.
At the end of the training program, the participant should be able to:
1 The objectives and the importance of the claims department
2 Claims department organizational structure
3 The legal requirements of the claim
Burden of proof
The cause of the loss is an insured risk
Proof The size of the loss
4 Main functions at claims department
Receipt of claims
Claims settlement
Inspection of accidents
Anti-fraud
Recovery
1 Standard coverages for insurance policies
2 The parties to the claim (first, second, third)
3 Insurance claim forms for a number of insurance policies with case studies
4 Deductible amounts and how to apply them
5 Claims settlement methods
Cash payment with case studies
Repair with case studies
Replacement with case studies
Reinstatement with case studies
6 Definition of quality and its dimensions
7 Quality standards
8 Focus on the customer
9 Handling complaints efficiently
10 Training employees to apply quality standards
1 Fraud definition
2 Internal and external fraud
3 Fraud Indications in various types of claims
4 Combating fraud in various types of claims
5 Claims Leakage
1 Stakeholders in claims department
2 Negotiating environment
3 Negotiation criteria
4 Planning for effective negotiation outcomes
5 Contents of the negotiation plan
6 Best practices in negotiation based on the principle of (Win-Win)
1 Technical claims reserve calculation
2 Incurred but not reported claim reserve IBNR
1 Introduction to reinsurance
2 Types of reinsurance treaties
3 The importance of reinsurance in handling catastrophic claims
Not Available
Names of the training programs that are integrated (enriched) with the training program:
Names of the training programs that after the training program:
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