Program Overview

Subject Information

Grading System

The grading system for this subject is HD/FL.

Duration

The duration of this subject is one session.

School

This subject is offered by the School of Accounting and Finance.

Enrolment Restrictions

Enrolment in this subject is restricted to Bachelor of Business (Insurance) students only.

Assumed Knowledge

The assumed knowledge for this subject is INS201.

Learning Outcomes

Upon successful completion of this subject, students should be able to:

• discuss the legal concepts relating to liability
• evaluate non-routine claims to accept or deny liability
• resolve claims disputes
• participate in negotiations related to claims
• finalise settlements
• process facultative and treaty claims
• settle claims
• review claims settlement policy and procedures

Syllabus

This subject will cover the following topics:

• Legal liability definition
• Identification of law affecting liability insurance
• Category identification
• Liability explanations
• Plaintiff legal rights and remedies
• Claim defence explanations
• Claim receipt
• Policy wording interpretation
• Claims analysis
• Claim legitimacy
• Proposed investigations
• Investigation and research of claim
• Settlement terms determination
• Advising settlement terms to clients
• Analysis responses
• Information identification
• Establishment of dispute grounds
• Instructions to relevant parties for information
• Explanation of insurer's obligations
• Dispute investigation
• Relating communication to personnel
• Justification of decisions
• Dispute resolution
• Document preparation
• Document completion
• Negotiation planning
• Compilation of information
• Conduct negotiations
• Confirming agreement
• Documentation review
• Specification of terms and conditions of offer
• Documentation preparation
• Arranging of final payments
• Obtaining settlement release
• Maintenance of finalised claims files
• Facultative and treaty reinsurance discussion
• Collecting information
• Claim coverage
• Payment calculation
• Claims settlement
• Claims data analysis
• Identification of trends
• Report preparation and procedures