This course describes the skills and knowledge required to manage non-routine and complex insurance claims, including: -
- identifying non-standard issues
- determining the business impact
- managing all aspects of the claims resolution process.
Learning Outcomes
By the end of this learning workshop, you should be able to: -
- Analyse claims to determine whether they are valid
- Evaluate the impacts of claims
- Determine settlement options
- Manage support arrangements to resolve claims
- Finalise claim process
Suitability
The course applies to those who apply specialist knowledge and functions when managing non-routine and complex insurance claims, such as major losses, bodily injury losses, long-term settlement, and claims involving legal procedures across international boundaries.
Day One
Analysing claims
In this module participants will: -
- Learn about non-routine and complex claims
- Explore different types of liability insurance
- Understand conditions and exclusions relevant to liability insurance
- Assess claims to determine whether they are valid and can be covered by the insurer
- Check whether information provided is accurate.
What is covered
- Liability claims management
- Non-routine and complex claims
- Types of liability claims
- Is the policy current and relevant
- Conditions specific to policy types
- Exclusions specific to policy type
- Without prejudice
- The stadium collapse
Evaluating claims and appointing specialists
On completion of this module participants will be able to: -
- Seek specialist advice
- Learn about reinsurance and notification requirements
- Analyse claims data
- Set claims reserves
- Explore ways to minimise losses.
What is Covered
- Gathering information
- Committing fraud
- Specialists
- Appointing a loss adjuster
- Notifying the reinsurers
- Investigation
- Report
- Setting a claim reserve
- Compare claims to payment projections
- Minimising the loss
- Taking urgent action
Day Two
Determining settlement options and supporting claimants
On completion of this module participants will be able to: -
- Investigate applicable legislation and industry requirements
- Learn about professional privilege
- Consider settlement strategies
- Seek advice from colleagues and others
- Support claimants.
What is Covered
- Legislation and industry requirements
- Industry Codes of Practice
- Insurance Codes of Practice
- Legal processes
- Deciding on a resolution
- Settlement strategies
- Seeking advise on settlements
- Get the contribution
- Review the reserve
- Support requirements
Recording information and changing procedures
On completion of this module participants will be able to: -
- Employ mediation skills
- Identify if changes are required to policies or procedures
- Report your findings
- Update records
- Finalise files.
What is Covered
- Dispute resolution
- Reviewing indemnity
- Identifying required changes to policy and procedures
- Reporting findings and updating records