Occupational Certificate: Insurance Claims Administrator Learnership

Occupational Certificate: Insurance Claims Administrator Learnership

The purpose of the Insurance Claims Administrator NQF Level 4 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.

What is Insurance Claims Administration?

 Insurance Claims Administrator is a nationally accredited qualification designed to prepare individuals for specialised roles in the insurance industry. This comprehensive programme equips learners with the knowledge and practical skills needed to handle and process insurance claims effectively and professionally.

As an Insurance Claims Administrator, you’ll be responsible for assessing, validating, and managing insurance claims while ensuring compliance with industry standards and client expectations. This qualification covers key areas such as claims procedures, customer service, data processing, regulatory compliance, and communication within an insurance environment.

What you will learn:
Throughout the course, learners will gain practical and theoretical knowledge in:

  • Insurance claims handling and processing

  • Industry-related legal and regulatory frameworks

  • Client service and communication

  • Fraud detection and risk awareness

  • Claims documentation and record-keeping

  • Teamwork and ethics in a financial services setting

This qualification is ideal for individuals looking to start or grow a career in the insurance sector, especially in administrative roles that require attention to detail, regulatory awareness, and strong customer service. 

Upon successful completion of the course, participants will be awarded an Occupational Certificate: Insurance Claims Administrator from the Quality Council for Trades and Occupations (QCTO). This certification validates the skills and knowledge acquired during the program. 

Module 1: Basic of insurance
  • Basics of insurance
Module 2: Professional Behaviour and Financial literacy
  • Professional Behaviour and Financial literacy
Module 3: Claims handling procedures
  • Claims handling procedures
  • Comment on risk improvements where applicable
Module 4: Claims handling processes
  • 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
Module 5: Long-term insurance
  • Receipt of notifications and verification processes regarding Long-term insurance
  • Assessment process regarding Long-term insurance
  • Decisions for payments to relevant stakeholders regarding Long-term insurance
  • Duration: 12 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 
  • Accreditation: QCTO
  • SAQA ID: 99668
  • Credits: 131
  • NQF Level: 4
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