PDI - Insurance Underwriting and Claims

Learning Outcomes

• evaluate insurable risks and suggest ways for loss prevention in regard to different types and nature of risks;
• assess moral and physical hazards under different business activities and recommend underwriting policy with appropriate premium, terms and portfolio management;
• apply basic working knowledge of different forms and types of reinsurance contracts and the relevant reinsurance market practice; and
• propose suggestions in managing claims services by applying principles of insurance law and claims for different disputes and claims settlement scenarios.

Learning Contents

1. Principles of rating and underwriting

• Nature of statistical base of insurance
• Risk data and insurance database, big data
• Rating structure as a means of obtaining and maintaining business
• Use of data to calculate pure risk premium
• Factors involved in pricing of insurance
• Premium equation

2. Risk assessment and underwriting of different types of Insurance

• Scope of cover
• Physical and moral hazards
• Standard and non-standard risks
• Assessment of risks for underwriting
• Factors for premium loading or reduction
• Reassessment of risks on renewal
• Underwriting philosophy including underwriting cycle and portfolio underwriting

3. Risk evaluation and loss prevention

• Reasons for risk surveys
• Characteristics of insurance surveyors' reports
• Nature of recommendations and requirements from surveyors
• Principles of loss prevention and risk reduction, including fire wheel, fire & theft protection

4. Reinsurance

• Purpose, type and method

5. Claims

• Legal principles relating to claims
• Key information on claim forms and reports
• Role and functions of adjusters and assessors in claims settlement
• Settlement of disputes including The Insurance Complaints Bureau, negotiation, mediation and arbitration
• Review of claims performance