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Life and disability claims: Legal and practical management

 

The demands placed on claims assessors in life offices have significantly increased in recent years, putting extraordinary pressure on the claims division.

The shifting legislative environment, combined with the wide variety of complex insurance products available in the market and growing customer demands, require those dealing with and managing claims to operate from a solid base of comprehensive knowledge stretching across a spectrum of related fields. In addition, claims divisions and claims assessors must be capable of building and following a sound claims management strategy in order to ensure the adherence to proper processes and consistency in decision making.

Join us for a four-month course, during which our panel of experts will discuss some of the pivotal aspects of the legal framework applicable to the life insurance industry; provide a high level overview of products in the individual and group risk environment; engage in practical claims assessment, management and review process activities and highlight best practice with regard to the handling of disputed claims in Ombudsman, mediation and litigation matters.

When and where?

The course runs over four months, with compulsory remote workshop sessions on the following dates:

  • 16 July 2021
  • 20 August 2021
  • 1 October 2021
  • 5 November 2021

The workshops will run remotely over Zoom, and the exact times will be confirmed closer to the time.

Course objectives

The objectives of the SCOR claims training course are to provide:

  • Legal, industry and product knowledge
  • Insight into claims and market related challenges
  • Experiential and practical claims assessment training
  • Optimal claims management skills
  • Dispute management capability

Course structure

The course consists of four modules, each of which will include a compulsory contact session. There is course work attached to each module that requires completion prior to the commencement of the next module. This includes short on-line tests, as well as case study work.

Module one focuses on fundamental aspects of the legal framework within which insurance operates in order to create an understanding of relevant laws that govern insurance and the management of a claim from beginning to end.

Module two focuses on a description of and analysis of life products in the South African market in order to obtain an overview of different policy types and an understanding of the meaning, interpretation and application of policy wording.

Module three focuses on the assessment of different types of claims and includes an experiential component in order to understand the claims process and learn how to assess claims in the most thorough manner possible.

Module four focuses on how to manage disputes from initiation through whatever further route they take, including litigation.

Case law, case studies, claims tasks and the application and use of assessment techniques all form part of this UCT certified experiential training course.

Each module will be assessed and must be passed in order to pass the whole course.

Who will benefit from this course?

This course will benefit senior assessors, claims managers and senior medical officers.

Presenter

The course will be presented by a panel of experts including senior and junior counsel who are experts in constitutional and insurance law; legal consultants specialised in insurance, medico-legal, commercial and fraud matters; risk consultants and claims and disability experts.

How much?

R12,000 per person

CPD accreditation

This course has been registered with the HPCSA and entitles you to 30 Ethics points on completion.

Certificate

A certificate of completion from UCT will be awarded to those who successfully pass the course assessments.

How to sign up

Complete and submit the registration form. You will then be given the payment information. Please note that registrations will not be accepted until payment has been made.

One or two days before the first workshop session, we will send you the Zoom link. You will need to register and use a password to access the course.

Registrations close three days before the course starts.

Download the brochure.