10162126Introduction to Loss Investigation (AIC 33)
Course Information
Description
The claim function, factors influencing claims, the steps involved in analyzing, negotiating and litigating first and third party claims, and the basics of property and liability losses will be covered in this class.
Total Credits
3
Course Competencies
  1. Analyze the various aspects of insurance regulation.
    Assessment Strategies
    by evaluating data and determining where it is found in the policy.
    by reviewing various federal regulations and identifying the purpose of each.
    by answering questions in Blackboard.
    Criteria
    you can identify the four parts of the policy.
    you can list the purpose of insurance regulation
    you can define the federal laws the impact the insurance industry.
    you can list the activities of insurance regulators.

  2. Use the claims handling process.
    Assessment Strategies
    by reviewing case studies and identifying the data needed to complete a claim form.
    by collaborating on case studies and identifying the steps the claims adjuster follows in handling a claim.
    by reviewing case studies in a group setting, students can work with others to share information and determine if the claim requires a reserve be set.
    Criteria
    you can identify, from a loss, the information necessary to complete a notice of loss form.
    you can identify and describe the steps involved in handling a claim.
    you can identify claims situations that require reserves.

  3. Explain the investigation process of a claim for a claims representative.
    Assessment Strategies
    by answering a set of questions in Blackboard.
    by evaluating a claim and identifying the type of liability present.
    by orally communicating to other students the results of the claim investigation.
    by submitting an experience summary to the instructor outlining an understanding of the material learned.
    Criteria
    you can list questions to ask an insured or claimant during a claims interview.
    you can identify and describe the various types of liability.
    you can identify and describe the results of the claims investigation.
    your reflection shows an understanding of the claims investigation process.

  4. Analyze bad faith claims handling and the defenses available to an insurer.
    Assessment Strategies
    by preparing a 2-3 page paper on an insurance fraud topic.
    by orally communicating a message of the costs of fraud to others.
    Criteria
    you can identify and describe the various types of insurance fraud in claims.
    your reflection shows an understanding of the costs of insurance fraud.

  5. Identify the indicators of insurance fraud in insurance claims.
    Assessment Strategies
    by answering a set of questions in Blackboard.
    Criteria
    you can identify common defenses available to insurers in the event of a bad faith claim.

  6. Evaluate the ethical challenges a claims professional faces and the resources available to assist in making proper decisions.
    Assessment Strategies
    by preparing a paper that describes your ethical beliefs.
    by working together with other students to develop a corporate code of ethics for an insurance business.
    by submitting an experience summary indicating what the student has learned.
    Criteria
    you can define your personal ethical beliefs.
    you researches a corporate ethics policy.
    your reflection shows a commitment to your ethical viewpoints.

  7. Differentiate between common negotiation techniques used by claims professionals and negotiation techniques that a claims adjuster should avoid.
    Assessment Strategies
    by orally answering questions in the classroom.
    Criteria
    you are able to identify the variables that affect a claim.

  8. Explain the activities a claims representative should use to manage a claim during litigation.
    Assessment Strategies
    by answering a set of questions in Blackboard.
    Criteria
    you show an understanding of litigation in the claims process.