INS314 Claims Management - Reinsurance (8)

This subject provides the student with the knowledge and skills to manage and resolve claims in Commercial Lines (Property, ISR, Contract Works)

No offerings have been identified for this subject in 2022.

Where differences exist between the Handbook and the SAL, the SAL should be taken as containing the correct subject offering details.

Subject Information

Grading System

HD/FL

Duration

One session

School

School of Business

Enrolment Restrictions

Bachelor of Business (Insurance) students only

Assumed Knowledge
INS201

Learning Outcomes

Upon successful completion of this subject, students should:
  • be able to apply legal terms and concepts to Personal Lines claims management
  • be able to evaluate nonroutine claims
  • be able to resolve claims disputes
  • be able to participate in negotiations to settle personal lines claims
  • be able to finalise settlement
  • be able to process facultative and treaty claims
  • be able to review claims settlement policy and procedures

Syllabus

This subject will cover the following topics:

Definition of Personal Lines and the distinguishing features of Personal Lines policies
Application of legal terms and concepts to Personal Lines claims
Evaluation of non-routine claims and implementation of the assessment / investigation required to determine acceptance or declinature of liability
Interpretation of policy coverage and analysis of the legitimacy of the claim
Determination of settlement terms in relation to policy terms and type, company policy, Codes of Practice and legislative requirements
Implementation of the negotiation process, document preparation and reporting arrangements with client and relevant parties concerning the settlement of the claim or denial of liability in accordance with legislative and regulatory requirements
Investigation process to support internal dispute resolution and preparation of documentation for external dispute resolution
Communication process with relevant stakeholders in the dispute resolution process to support dispute resolution in a timely, considerate and, where possible, non-litigious manner without resorting to formal conciliation services
Settlement documentation, file preparation and recovery procedures
Claims reserving and reporting processes
Reinsurance - facultative and treaty claims and reporting processes for settlement with reinsurers
Portfolio data collection, review and reporting including audits of field operations, settlement campaigns and special loss studies
Content
The risks covered by commercial lines may include:
Contract Works
Business Interruption
Material Damage
Principles of insurance and legislation may include:
Duty of utmost good faith
Duty of disclosure
Misrepresentation

The information contained in the CSU Handbook was accurate at the date of publication: May 2022. The University reserves the right to vary the information at any time without notice.

Back