Overview
The Executive Certificate in Insurance Claims Management is designed to strengthen professional capability in managing the claims function within insurance organisations. Claims management plays a central role in the insurance value chain, ensuring that policyholders receive fair and timely compensation while protecting insurers from unnecessary losses and operational inefficiencies.
This programme provides participants with a structured understanding of the claims environment, including claims management strategies, organisational structures, and the legal and regulatory frameworks governing claims handling. Participants also gain practical insight into claims service management, customer expectations, complaint handling, and the role of claims in maintaining customer trust and retention.
The programme further explores technical aspects of claims management such as reserving practices, fraud detection, subrogation, recoveries, and the application of information technology in claims operations. By integrating operational, technical, and strategic perspectives, the programme equips professionals with the knowledge required to manage claims functions effectively and contribute to efficient insurance operations.
Professional Recognition
The Executive Certificate in Insurance Claims Management forms part of the professional development pathway offered through the IIEA E-Academy™ and is designed to strengthen technical capability in insurance claims management within the insurance industry.
The programme provides structured training covering claims management strategy, claims operations, reserving practices, fraud prevention, and claims service delivery, enabling professionals to develop the knowledge required to manage claims functions effectively.
Professionals who complete the programme demonstrate a strong understanding of claims management practices and the role of the claims function in supporting fair settlements, customer service, and sustainable insurance operations.
Who Should Enrol
This programme is designed for professionals involved in insurance claims operations and management, including:
- Insurance claims officers and claims administrators
- Claims supervisors and claims managers
- Insurance underwriters seeking insight into claims operations
- Insurance brokers and intermediaries supporting client claims
- Risk and compliance professionals within insurance organisations
- Professionals seeking to strengthen their expertise in insurance claims management
What You Will Learn
Participants will gain practical knowledge and understanding of:
- The role of claims management in insurance operations
- Claims management strategies and claims service delivery
- Claims reserving principles and cost control practices
- Claims investigation, fraud detection, and dispute resolution
- Claims handling procedures and regulatory considerations
- Managing claims operations, service providers, and outsourcing arrangements
Learning Pathway
This programme forms part of the IIEA E-Academy Learning Pathway Framework™ for Advanced Insurance Professionals, designed to strengthen technical expertise across key areas of insurance practice.
Certification
Participants who successfully complete the programme requirements will receive the Executive Certificate in Insurance Claims Management.
This programme represents an advanced professional development programme designed to strengthen claims management capability within insurance organisations.
Related Programmes
This programme complements other advanced technical insurance programmes such as:
- Executive Certificate in Risk Management and Insurance
- Executive Certificate in Insurance Underwriting Management
- Claims Fundamentals
- Motor Claims Practices
and helps develop strong capability in managing claims operations, improving claims service delivery, and strengthening insurance operational performance.
Download BrochureLearning Outcomes
By the end of this course, you should be able to:
- Understand the claim processes, concepts, and procedures;
- State the key issues relating to claims in specific types of policies
- Explain the importance of IT and quality management and their impact on claim management;
- Explain the functions of outsourcing companies and intermediaries in the claim process;
- Understand the rationale for claims estimating and reserving; and
- Discuss fraudulent claims, disputes and litigation in the claims process.
Course Outline
- 1.1: Learning Outcomes
- 2.1: Claims Management Strategy
- 2.2: The Claims Environment
- 2.3: Claim Philosophies
- 2.4: Organisation Design and Structure
- 2.5: Policy Interpretation
- 2.6: Legislation and Regulation
- 2.7: Supply Chain
- 3.1: Customer Expectations
- 3.2: Customer Retention
- 3.3: Complaint Handling
- 3.4: Policyholder Litigation and Breach of Contract
- 3.5: Court Awards
- 3.6: Varying Requirements
- 4.1: Reserving Philosophies
- 4.2: Design and Implementation of Claims Handling Procedures
- 4.3: Civil Procedure Rules
- 4.4: Pre-Action Protocols
- 4.5: Process Review and Quality Management
- 4.6: Compliance with Claims Procedures
- 4.7: Fraudulent Claims
- 4.8: Ethical Aspects
- 4.9: Information Technology
- 4.10: Management Information Systems
- 4.11: Reinsurance
- 4.12: Subrogation and Recoveries
- 5.1: Claims Handling Operations
- 5.2: Segmentation
- 5.3: Authorities
- 5.4: Outsourcing
- 5.5: Delegated Authorities
- 5.6: Catastrophe Management
- 5.7: Call Centre Management
- 5.8: Supplier and Relationship Management Panels
- 5.9: Market Practice
- 6.1: Cost Control
- 6.2: Estimating and Reserving
- 6.3: Claims, Underwriting and Pricing
- 6.4: Actuarial Reviews
- 6.5: Leakage
