Claims Evaluation and Resolution - CLEQ


A claim's life cycle begins when an incident is reported to the insurance company that might-or might not-ultimately pay a covered claim. Once the incident has been reported, the claim is assigned, an initial reserve is established, and files are set up and assigned to an adjuster. After verifying coverage, the adjuster launches an investigation. Claims investigation is followed evaluation and, ultimately, resolution.

This course focuses on the final two key aspects of the larger claims adjustment process -- evaluation and resolution. Successfully managing those aspects helps manage financial impacts and leads to better claims resolutions and customer relations.

Learning Objectives

Upon completion, students will be able to:

  • explain how claims evaluation and negotiation fit 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
  • describe an insurer's duties and options in resolving a claim
  • explain how negotiation, litigation, and recovery fit into the overall claims adjustment process

Designed For

P/C Agents and Brokers, P/C Adjusters
International Risk Management Institute, Inc. (IRMI) is the premier provider of risk and insurance continuing education and reference publications, and is considered the ultimate authority by leading insurance practitioners. Written by industry experts, IRMI courses provide the most up-to-date, practical and reliable information possible.

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