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2.2 REINSURANCE CLAIMS MANAGEMENT FOR RUN-OFF ORGANISATIONS
A course providing an opportunity for delegates to develop their understanding of the general practice and principles of reinsurance claims handling, assessment and settlement particularly in the run-off context. It will discuss how to apply the principles of insurance and reinsurance to claims of any class of business. The emphasis will be on practice in the London reinsurance market and reference will therefore be made be made to practice and requirements in both the UK and the USA, with comparisons between the two where useful.
· Role of the claims department, and its relationship with other departments and operations in a run-off organisation.
· Principles of insurance - insurable interest, proximate cause, indemnity, average, reinstatement. The importance of policy definitions. Principles and purposes of reinsurance - facultative and treaty, proportional and excess of loss; key clauses for claims handling in reinsurance wordings.
· 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 the key elements of the decision making.
· Legal bases of claims - first party and third party; tort and contract: insurance and reinsurance.
· Different requirements for handling property and liability claims - insurance and reinsurance.
· Use of loss adjusters, lawyers and other outside experts: insurance and reinsurance.
· Different roles of lawyers in disputed liability claims - how to handle the potential conflicts.
· 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.
· Litigation procedures and handling disputes; typical reinsurance arbitration procedures; brief introduction to ADR and mediation.
· Dealing with inspections of records/audits to maximum advantage - inwards and outwards.
· FSA regulatory impact on claims handling and audits.
· London market claims agreements; responsibilities of the leader.
On completion of the course delegates will have a knowledge of the role and the necessary skills of a reinsurance claims handler in the London market; the application of re/insurance 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 the distinctions between first party and third party (liability) claims; litigation, arbitration and dispute resolution procedures; aspects of FSA regulation which directly pertain to claims handling, all with particular reference to a run-off organisation.
The course will be appropriate for all those beginning work in a run-off reinsurance claims department, and anyone else seeking an overview of claims handling in the run-off context.
An interactive presentation including lecture, interactive discussion, case studies and exercises.