Course Overview
The purpose of this qualification is to prepare a learner to operate as an insurance claims administrator (insurance claims assessor). An insurance claims administrator (insurance claims assessor) assesses the validity of the claim against the contract in order to determine or recommend whether to settle or reject a claim and provide comments on risk improvements and moral risks.
Module 1: Insurance Processes
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- Basics of insurance
- Receipt of notifications and verification processes regarding long-term insurance
- Verification processes regarding short-term insurance
- Assessment process regarding long-term insurance
- Participation of assessment process regarding short-term insurance
- Making recommendations regarding short-term insurance
Module 2: Claims Handling Procedures
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- Claims handling procedures
- Receive a basic claim in order to assess the loss / damage and verify the validity of the contract
- Assess the claim to determine validity
- Recommend to settle, conditionally settle or reject the claim
- Verification processes regarding statutory claims
- Assessment processes regarding statutory claims
- Assessment processes regarding health care
- Finalisation processes of statutory claims
Module 3: Financial Literacy and Ethics
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- Professional behaviour and financial literacy
- Comment on risk improvements where applicable
- Decisions for payments to relevant stakeholders regarding health care claims
- Decisions for payments to relevant stakeholders regarding long-term insurance
Module 4: Health Care Verifications
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- Receipt of notifications and verification processes regarding health care
- Duration: 24 Months
- Delivery: Classroom/Online/Blended
- Entry Requirements NQF Level 4 qualification or 3 years work experience in the Insurance industry
Qualifying learners could follow a career in:
- Insurance Claims Administrator/Assessor
- Claims Adjuster
- Claims Analyst
- Customer Service Representative
- Occupational Certificate – Insurance Claims Administrator System Support
- Accreditation: QCTO
- SAQA ID: 99668
- NQF Level: 4
