Claims Investigation & Loss Adjustment Training Course

Course Overview

Learning Objectives

• Analyze the principles and stages of professional insurance claims investigation.
• Develop structured approaches for investigating the circumstances and causes of loss.
• Evaluate policy coverage, exclusions, conditions, limits, and deductibles during claims assessment.
• Apply techniques for collecting, validating, and documenting claims evidence.
• Assess causation, liability, damage, quantum, and potential financial exposure.
• Evaluate physical damage and financial losses using appropriate assessment methodologies.
• Apply loss adjustment principles to property, commercial, industrial, liability, and business interruption claims.
• Identify inconsistencies, gaps, exaggeration indicators, and potential fraudulent activity.
• Strengthen the quality and reliability of loss adjustment reports and recommendations.
• Evaluate repair, replacement, mitigation, and other loss-related costs.
• Identify recovery, subrogation, contribution, and salvage opportunities.
• Develop well-supported recommendations for claims settlement and closure.

Who Should Attend

Learning Outcomes

• By the end of the course, participants will be able to:
• Plan and conduct structured investigations of insurance claims.
• Gather, validate, and organize relevant documentary, physical, and technical evidence.
• Evaluate policy coverage and identify potential coverage issues.
• Establish the likely cause and circumstances of loss.
• Assess liability and determine the parties potentially responsible for the loss.
• Evaluate physical damage, financial loss, repair costs, and replacement requirements.
• Assess business interruption and consequential loss exposures.
• Identify inconsistencies, information gaps, and indicators requiring further investigation.
• Prepare clear, objective, and evidence-based loss adjustment findings.
• Evaluate mitigation measures and their impact on the final claim value.
• Identify recovery, subrogation, contribution, and salvage opportunities.
• Develop technically sound recommendations to support fair and controlled claim settlement.

Course Outline