Overview
The Executive Certificate in Insurance Claims Management supports workforce capability development within modern insurance environments by strengthening employee understanding of claims operations, claims service delivery, fraud management, customer experience, and operational effectiveness within insurance organizations.
Claims management plays a critical role across the insurance value chain by supporting fair settlements, customer confidence, operational efficiency, fraud control, and sustainable insurance performance. The programme develops practical understanding of claims operations, claims management strategies, customer communication, reserving practices, dispute resolution, fraud management, recoveries, and regulatory considerations influencing claims handling practices.
The programme also examines claims governance, operational efficiency, customer service excellence, and the application of technology within modern claims management environments.
Professional Recognition
The Executive Certificate in Insurance Claims Management supports professional capability development in claims operations, fraud management, customer service delivery, and operational effectiveness through structured professional learning and applied insurance industry understanding.
Employees who successfully complete the programme demonstrate strengthened understanding of claims management principles, claims handling practices, fraud prevention, operational controls, customer communication, and sustainable claims operations within insurance environments.
The programme supports continuous professional development and workforce capability growth by strengthening employee readiness to contribute effectively within claims operations, customer service environments, fraud management initiatives, and operational improvement programmes across the organization.
Who Should Enrol
This programme supports employees involved in claims operations, insurance service delivery, fraud management, customer engagement, and operational insurance functions, including:
- claims officers and claims administrators
- claims supervisors and claims managers
- underwriting professionals seeking deeper understanding of claims operations
- insurance brokers and intermediaries supporting claims processes
- customer service and operations personnel
- risk, compliance, and fraud management professionals
- professionals seeking to strengthen capability in insurance claims management
What You Will Learn
Employees undertaking this programme will strengthen their understanding and practical application of:
- claims management within insurance operations
- claims service delivery and customer experience management
- claims reserving and cost management practices
- claims investigations, fraud detection, and dispute resolution
- claims procedures and regulatory considerations
- managing claims operations and service providers
- technology and digital systems within claims operations
Learning Pathway
This programme forms part of the organization’s structured learning pathway framework supporting workforce capability development across claims operations, customer service, fraud management, operational effectiveness, and technical insurance practice.
Certification
Employees who successfully complete the programme requirements will receive the Executive Certificate in Insurance Claims Management together with a digitally verifiable professional certification credential recognizing successful completion and demonstrated capability in insurance claims operations and claims management practices.
Related Programmes
This programme complements other professional development pathways across the organization including:
- Executive Certificate in Risk Management and Insurance
- Executive Certificate in Insurance Underwriting Management
- Claims Fundamentals
- Motor Claims Practices
- Insurance Fraud for Claims Professionals
These programmes collectively support workforce capability development across insurance operations, customer service, fraud management, and 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
