This course is a premium course it can be accessed either by individual purchase or through a premium subscription
This course explains the methods used by insurance claims and investigative personnel to investigate a first-party property claim. The insurance claims professional must obtain as much material information available to the insured and witnesses. The course discusses how the claims professional can -- by means of the conditions of the insurance policy -- compel the insured to produce documents and appear and testify at examination under oath. The claims professional conducts his or her investigation and enters into an agreed scope of loss, statement of loss, and proof of loss.
The course covers the following:
- How a claim is investigated.
- The obligations of the insured to the insured who presents a claim.
- The obligation to present to the insurer relevant documents.
- The obligation of the insurer to review and analyze relevant documents.
- The need for an agreed scope of loss.
- The preparation of the statement of loss.
- The preparation and evaluation of the sworn statement in proof of loss.
- The facts and investigation results that must be included in the adjuster’s reporting.
- The public adjuster and his or her duties to the insured and the insurer.
- The need to establish that conditions have been met.
Learning Objectives
- Explore how a claim is processed by an insurance professional.
- Explore the various methods used by an insurance claim professional deals with a first party claim.
- Explore the obligations of the insured to assist in the processing of a claim.
- Identify how the claims professional works to resolve a claim.
- Identify how the insurer establishes that all policy conditions have been fulfilled.
- Identify how an insurer determines the amount of loss compensable under a policy.
- Explore the methods used by an insured to cooperate with the investigation.
Included In Certifications
This course is included in the following Certification Programs:
16 CoursesCorporate Property Insurance Certification
- Introduction: Excellence in Claims Handling
- How to Acquire a First-Party Property Insurance Policy
- How to Read and Understand an Insurance Policy
- The Necessity of an Honest and Complete Insurance Application
- The Basics of the Law of Contracts for the Insurance Professional
- Ethics for the Insurance Professional
- What is the Problem with Fraud?
- Interviewing Techniques for the Insurance Professional
- Investigation of a First-Party Property Insurance Claim
- The Creation of a Scope, Statement, and Proof of Loss
- The Duties of an Insured Presenting a First-Party Property Claim
- The Insurance Examination under Oath (EUO)
- Insurance Fraud Prevention
- Compliance with Special Investigation Unit Regulations
- Compliance with Good Faith Settlement Practices Regulations
- The Obligations of a Public Insurance Adjuster
Prerequisites
No Advanced Preparation or Prerequisites are needed for this course. However, it is recommended to take the other courses in the series prior to completing this one.