Insurance Claims Unraveled – How to Avoid the Pitfalls

This training will review the rapidly evolving field of insurance claims and will provide an update on the most recent case law. Presenter Simon Cooper will cover the process of claims presentation, the pitfalls which await the unwary plus the key contractual issues.

The session will also consider the consequences of failing to present or handle claims appropriately. How to make an insurance claim, the importance of contractual notification requirements and the consequences of a failure to notify claims correctly will also be examined.

Notifying ‘circumstances’ which may give rise to a claim, who can make a claim and who is covered under the insurance will be explored, together with key claims terms including the operation of policy exclusions and contractual warranties.

COURSE CONTENT

Introduction

• How to make an insurance claim
• The importance of contractual notification requirements
• The consequences of a failure to notify claims correctly
• Notifying ‘circumstances’ which may give rise to a claim
• Who can make a claim and who is covered under the insurance?
• Key claims terms including the operation of policy exclusions and contractual warranties
• Claims co-operation and claims control clauses – what they mean and how they work
• How claims are calculated; what happens if insurers delay payment?
• Fraudulent claims – what constitutes fraud in the claims process and what are the consequences?
• Insurers right to subrogate
• Resolving claims disputes – different forms of dispute resolution; the role of the Insurance Ombudsman

TRAINING METHODOLOGY

The training methodology combines lectures, discussions, group exercises and illustrations. Participants will gain both theoretical and practical knowledge of the topics. The emphasis is on the practical application of the topics and as a result participant will go back to the workplace with both the ability and the confidence to apply the techniques learned to their duties.