Claims Evaluation

Overview

After the adjuster has finished investigating the claim and has verified that coverage exists, the next state in the claims process is evaluation. Evaluation involves determining the monetary value or worth of the amount being claimed as well as what is allowable under the insurance policy.

The course provides a review of the entire claims-handling process, emphasizing where evaluation fits into the process, and noting the ethics associated with claims evaluation. It explores the evaluation process used in first-party claims and then examines liability claims, which require the evaluation not only of the claimant’s damages but also the insured’s liability. Case applications are included in the course to better explain and illustrate key concepts.   

Learning Objectives

Upon completion of this course, students will be able to:

  • explain how claims evaluation fits into the overall claims adjustment process
  • describe the processes used in evaluating first-party and third-party claims
  • explain the distinction between evaluating damages and evaluating liability
  • explain and evaluate various techniques used in establishing claims reserves

Designed For

P&C producers, adjusters, public adjusters and claims professionals
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