Often, situations arise from loss events that awaken the insurance audience to the need for preventive measures. However, claims have been noted as the most important channels and a specific link that shapes customers' overall perception of their insurance company. Claims handling is a mirror to the customer, enabling insurance companies to improve customer acquisition, expectations, retention, and their business vision to enhance product development and company profitability. Therefore, the engine for claims management actions, accuracy, efficiency, and effectiveness is key to controlling costs, managing risks, and meeting the necessary expectations to ensure appropriate underwriting for the portfolio.

Insurance laws and regulations largely concern the regulatory forces governing insurance documents and claims. This course in this field provides participants with a basic understanding and an introduction to insurance laws and regulations to develop a deeper understanding of this topic, as well as how to effectively manage insurance risks and develop strategies for handling claims.

Who Should Attend?

• Professionals working in various fields related to insurance.
• Individuals wishing to advance in the insurance industry or start a new career in insurance.
• Candidates with a solid foundation in insurance law and are ready to enhance their qualifications.
• Newcomers to the insurance industry who work in customer service, deal with claims, or have other specific roles.
• Lawyers and other business professionals working indirectly with contracts and seeking basic knowledge in regulating insurance policies and handling claims.

Knowledge and Benefits:

After completing the program, participants will be able to master the following:

• Gain a detailed understanding of the real issues faced by insurance agents and claims professionals.
• Learn about the types of insurance available.
• Understand how to measure risks, analyze market structure, and identify key players.
• Learn how to develop better insurance policies.
• Identify the appropriate strategic option.
• Improve the relationship between the insurer and customers.
• Complete the claims handling process and monitoring appropriately.

• Introduction to Insurance

  • Differentiating between compulsory and optional insurance.
  • Overview of the main types of insurance: life, property, and health insurance.
  • The role of insurance in providing financial protection for individuals and businesses.

• The Importance of Insurance in the Economy

  • The direct impact of insurance on the stability of the economic system.
  • The role of insurance in reducing economic risks and aiding recovery from crises.
  • The contribution of insurance to fostering sustainable economic growth.

• The Legal Framework of Insurance

  • The fundamental principles governing the insurance industry.
  • The relationship between insurance laws and civil and commercial legislation.
  • The role of regulations in organizing the market and protecting the rights of involved parties.

• The Legal System of Insurance in Different Countries

  • A comparison of legal systems in developed and developing countries.
  • The impact of national legislation on the insurance industry.
  • Challenges associated with implementing national legal systems.

• International Regulations for Insurance

  • The role of international organizations, such as the International Association of Insurance Supervisors (IAIS), in harmonizing standards.
  • The effect of international agreements on national insurance regulations.
  • Collaboration between regulatory bodies across countries to enhance market effectiveness.

• International Agreements in Insurance

  • The impact of international agreements on local insurance policies.
  • The role of bilateral agreements in facilitating trade exchanges.
  • Legal challenges associated with compliance to international standards.

• Legislation Specific to Types of Insurance

  • Legal requirements for life insurance and their impact on companies and beneficiaries.
  • The legal framework for regulating property insurance.
  • Legislation specific to health insurance and its mechanisms for consumer protection.

• Regulatory Guidelines for the Insurance Industry

  • The role of regulatory bodies such as the Financial Conduct Authority (FCA) in ensuring market integrity.
  • Oversight strategies to ensure compliance with legal standards.
  • Implementing governance standards in insurance companies to ensure accountability and compliance.

• Recent Legal Amendments in Insurance

  • New laws related to digital transformation in the insurance industry.
  • Legal developments regarding consumer protection rights in insurance.
  • The impact of legal amendments on insurance companies and beneficiaries.

• Principles of Insurance Claims

  • The legal foundations for submitting claims according to insurance contracts.
  • Documentation and paperwork required to support insurance claims.
  • Understanding the role of service providers in processing and reviewing claims.

• Systems Related to Claims Processing

  • The legal and technical procedures followed to examine and assess claims.
  • Criteria for approving or rejecting claims in accordance with legal regulations.
  • Dispute resolution mechanisms in cases where claims conflict with agreed terms.

• Legal Risks in Claims Processing

  • Issues related to fraud in submitting insurance claims.
  • Legal responsibilities of insurance companies in claims processing.
  • Risk management strategies related to legal issues in claims procedures.

• Insurance Fraud

  • Different types of insurance fraud and their impact on the market.
  • Legislation aimed at combating fraud in the insurance industry.
  • Mechanisms adopted by companies to prevent fraud and ensure the integrity of insurance operations.

• Legal Obligations of Insurance Companies

  • The responsibilities of insurance companies towards their clients and beneficiaries.
  • Consumer rights in insurance and their legal protection.
  • The obligations of insurance companies in dispute resolution and addressing legal issues.

• Future Challenges in Insurance Laws

  • The impact of technological shifts on legal regulations in the insurance industry.
  • Anticipated changes in consumer protection laws in the future.
  • Future trends in local and international insurance legislation.