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2.1 PRINCIPLES OF INSURANCE & REINSURANCE CLAIMS MANAGEMENT
An introductory/intermediate level course providing an opportunity for delegates to develop their understanding of the general practice and principles of claims handling, assessment and settlement, and of the part claims handling plays in the reinsurance process. It will show delegates how to apply the principles of insurance and reinsurance to claims of any class of business.
· Role of the claims department, and its relationship with other (re)insurance organisation departments and operations. Functions within the claims department.
· How to gain added value from the claims function.
· Principles of insurance - insurable interest, indemnity, average, reinstatement. The importance of policy definitions.
· Principles and purposes of reinsurance - facultative and treaty, proportional and excess of loss. Application of reinsurance to claims from cedants: following the fortunes, and following the settlement. What happens if the reinsurance and insurance are not "back-to-back".
· Case study: "A claim is made" - a walk-through description of reinsurance claims handling processes from first advice to settlement., with reference to the reinsurance contract wording, and an examination of the key elements of the decision making.
· Legal bases of reinsurance claims - key clauses in reinsurance wordings and the legal approach to interpretation of wordings.
· Different requirements for handling property and liability claims.
· Use of loss adjusters, lawyers and other outside experts.
· Handling inspections of records and audits to maximum advantage - both inwards and outwards.
· The "perfect" claims file. Maximising your outwards claims recoveries
· Introduction to loss reserving; reasons for reserving; what is an accurate reserve; IBNR; the importance of technical reserves in insurance accounts - with simple worked exercises.
· FSA regulatory impact on claims handling and audits.
· Some considerations for USA and worldwide business.
· London market claims agreements; role of the bureaux; responsibilities of the leader.
On completion of the course delegates will have a knowledge of the role and necessary skills of a claims handler; the application of insurance and reinsurance principles to claims evaluation and settlement; claims department procedures; elements and importance of claims reserving; the legal bases (tort and contract) of insurance claims; and aspects of FSA regulation which directly pertain to claims handling.
The course will be appropriate for all those beginning work in a reinsurance claims or underwriting department, and anyone else seeking an overview of claims handling.
The course will include lecture, interactive discussion and case studies and exercises.