Program Brief

The Insurance Claims Handling Program focuses on providing participants with a comprehensive understanding of claims management. The program covers the fundamental principles of claims handling, an understanding of insurance products and related services, as well as the considerations and procedures involved in claims management. It also addresses the structure of the claims function, effective settlement methods, and the management of associated expenses. The objective is to enhance participants' ability to apply best practices in claims management, ensuring efficiency and fairness in processing and settlement.

Program Goals

At the end of the training program, the participant should be able to:

  • Understand the general principles in the claims handling process.
  • Understand insurance products and associated services.
  • Understand claims considerations and administration.
  • Understand claims handling procedures and related claims services.
  • Understand the claims function and how it may be structured.
  • Understand claims settlement.
  • Understand how expenses are managed.
Program Agenda
Module 1: The General Principles in the Claims Handling process
  • 1 Describe the legal requirements for a valid claim

    • 2 Describe the different types of policy conditions relating to claims

      • 3 Describe what documentary and supporting evidence are required when notifying a claim

        • 4 Explain what is meant by proximate cause and how it is applied

          Module 2: Insurance Products and Associated Services
          • 1 Describe features, extensions and exclusions of motor policies

            • 2 Describe features, extensions and exclusions of household, gadget, travel and extended warranty

              • 3 Describe features, extensions and exclusions commercial property and pecuniary policies

                • 4 Describe features, extensions and exclusions commercial liability policies

                  • 5 Describe features, extensions and exclusions of health policies

                    Module 3: Claims Considerations and Administration
                    • 1 Describe the role of the claims department

                      • 2 Explain the importance of service standards and managing customer expectations

                        • 3 Explain the different parties to an insurance claim

                          • 4 Explain the importance of claims estimating and how reserving operates

                            • 5 Explain how fraud affects insurance claims

                              • 6 Describe the ways in which a claims department may ensure that customers are treated fairly

                                • 7 Describe how disputes and complaints could be resolved or escalated

                                  Module 4: Claims Handling Procedures and related Claims Services
                                  • 1 Describe claims handling procedures for motor policies

                                    • 2 Describe claims handling procedures for household, gadget, travel and extended warranty

                                      • 3 Describe claims handling procedures for commercial property and pecuniary policies

                                        • 4 Describe claims handling procedures for commercial liability policies

                                          • 5 Describe claims handling procedures for health policies

                                            • 6 Explain the roles of externport services used in the claims processal sup.

                                              Module 5: The Claims Function and How it may be Structured
                                              • 1 Describe the key features, structure and objectives of different claims systems

                                                • 2 Describe the claims function as it appears in functional and divisional structures

                                                  Module 6: Claims Settlement
                                                  • 1 Describe the way that claims can be settled.

                                                    • 2 Describe why a full indemnity may not always be paid.

                                                      • 3 Explain how insurers can recover the cost of claims.

                                                        • 4 Describe the methods used to mitigate the risk of untraced/uninsured drivers

                                                          Module 7: Expense Management
                                                          • 1 Describe the role of the claims manager

                                                            • 2 Explain what claims leakage is and how to identify and reduce it

                                                              • 3 Explain the types of financial monitoring and how this can impact an insurance company results

                                                                • 4 Explain the basis and significance of reserving practice.

                                                                  Program Requirements

                                                                  Not Available

                                                                  Program Path

                                                                  Names of the training programs that are integrated (enriched) with the training program:

                                                                  • Not Available

                                                                  Names of the training programs that after the training program:

                                                                  • Not Available
                                                                  Program Method
                                                                  • Lecture
                                                                  • Brainstroming
                                                                  • Practical Implementation
                                                                  • Dialogue Teams
                                                                  Evaluation Method
                                                                  • Pre Exam
                                                                  • Post Exam
                                                                  • Simulation Test for professional exam
                                                                  Training Type
                                                                  • In Class Training
                                                                  • Online Training
                                                                  Partners

                                                                  Not Available

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