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Claims Practice (M85)

The objective of this unit is to develop knowledge and understanding of the fundamental principles and practices of claims practice and how claims are handled.

The default Enrolment option for this unit includes:

  • Latest version of the core learning content, in digital format only.
  • Assessment entry.

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Claims Practice (M85) considers the practical aspects of handling a claim; from receipt to settlement (whatever that means in each case).  It deals with the rules within which the claims handler must operate, as well as explain those of their duties which do not relate directly to the customer, e.g. the setting of claims reserves and ensuring that reinsurance and other recoveries are made.

Not all claims arise directly from the insurer's own policyholder. Some will come from persons, third parties, who have a problem with the policyholder, having experienced a loss because of their actions. We will see the law behind such claims and how to settle them. Some of these claims may end up being dealt with in a court of law. Consequently, they must be dealt with in a certain way to comply with the law and court procedures and this study text explains this.

Finally, we will look at what to do when a customer is not satisfied with how their claim has been resolved, what rules apply and the techniques of dispute resolution.

Building a successful career in insurance

This course is ideal for claims handlers and for those looking to gain knowledge and understanding of claims practice. Claims Practice (M85) counts towards a Diploma in Insurance. It may also count towards the Advanced Diploma in Insurance.

Please note it is assumed that you already have knowledge of the fundamental principles of insurance as covered in Insurance, Legal and Regulatory (IF1) or equivalent examinations.

 

Summary of learning outcomes 

  1. Understand key aspects of claims handling.
  2. Understand key aspects of handling personal lines claims, including motor.
  3. Understand key aspects of handling property claims, including business interruption.
  4. Understand key aspects of handling third party liability claims.

Assessment

  • Coursework assignment with 10 compulsory short answer questions; and a 60 minute exam comprising 50 multiple-choice questions (MCQs)
  • 60% coursework nominal pass mark
  • 65% exam nominal pass mark
  • The average pass rate for those completing Diploma in Insurance mixed assessment units in full is currently 91.7%

Study material - editions available

2021-22 edition (applicable to exams sat 01 May 2021 to 30 Apr 2022).