Claims Management Processes Course
Online 300-hour course in claims management processes. 6 modules covering Law 50/1980 (Insurance Contract, arts. 16 to 20), Order ECO/734/2004 (customer service) and Guidewire ClaimCenter. Assigned tutor and open enrolment.
Claims Management Processes Course — studying from India
India's insurance market is expanding, with life and general insurers, reinsurers and technology providers based in Mumbai, Delhi NCR, Chennai and Hyderabad. The Insurance Regulatory and Development Authority of India regulates the sector, and the Life Insurance Corporation of India and General Insurance Corporation of India are prominent public players. Insurers increasingly use data analytics, telematics and risk modelling, creating demand for actuarial and data professionals. Engineers and analysts in this area build pricing models, underwriting tools and risk assessment platforms for motor, property and health insurance.
Fees for India: ₹84,500 (Indian Rupee), with instalments and employer sponsorship available.
Relevant bodies in India
Typical roles
Questions from India
Is there a recognised actuarial or risk professional body in India for this area?
The main professional body for actuaries in India is the Institute of Actuaries of India (IAI), and insurers are regulated by IRDAI. SEIUM's qualifications are private and not accredited by any national body, so they do not give you IAI membership or any official status. Check the IAI's own exam and membership requirements before deciding.
Which employers in India hire for insurance, risk and actuarial data roles?
Life and general insurers, reinsurers, banks, consultancies and risk analytics teams hire for data and risk roles. Employers set their own hiring standards and decide how much weight to give a private qualification. Practical experience with data and modelling usually matters a great deal, so the course is best viewed as one part of your profile.
How is the programme delivered and how is it paid for in India?
The programme is delivered entirely online in English, so you can study from home with no student visa needed. Each student has an assigned technical tutor and completes a final project. Fees are payable in instalments, and employer sponsorship is possible, which many working professionals use to manage cost alongside their job.
Take the controls.
Run a real engineering trade-off from this field. Move the sliders, watch the model react in real time and beat the challenge.
What you will be able to do
Describe the phases of the claims management process.
Carry out the opening and initial coverage analysis.
Build the claim file with the necessary documentation and evidence.
Settle and pay the claim in compliance with legal deadlines.
Apply quality controls and complaints management.
Propose process improvements based on indicators.
Develop an integrative project redesigning the claims process.
Who it's for
- Claims handler looking to specialise in Claims Management Processes.
- Claims team leader looking to specialise in Claims Management Processes.
- Process quality analyst looking to specialise in Claims Management Processes.
- Customer service manager in insurance looking to specialise in Claims Management Processes.
- Property claims manager looking to specialise in Claims Management Processes.
- Continuous improvement manager looking to specialise in Claims Management Processes.
- Engineering or science graduates seeking to enter insurance companies.
What you'll work with
- Law 50/1980 (Insurance Contract, arts. 16 to 20)
- Order ECO/734/2004 (customer service)
- Royal Decree 1060/2015 (ROSSEAR)
- ISO 9001 (quality management)
- ISO 10002 (complaints handling)
- Law 35/2015 (traffic compensation scale)
6 modules · 300 h
1.1Phases of the process from start to finish1.2Internal and external stakeholders1.3Claim types and differentiated routes1.4Department objectives and the tensions between them1.5Main process indicators1.6Support systems and documentation1.7Legal framework for claims handling1.8Sector vocabulary and acronyms1.9Most common critical points1.10Exercise: process map for a line of business
2.1Notification channels and their design2.2Minimum data for first notification2.3Policy and validity verification2.4Preliminary coverage check2.5Claim file opening and initial reserve2.6Triage and file assignment2.7Initial communication to the policyholder2.8Activation of assistance services2.9Documentation to request2.10Practice: claim opening protocol
3.1Appointment and monitoring of loss adjusters3.2Damage assessment and estimates3.3Detailed coverage analysis3.4Determination of liability3.5Third-party management and agreements3.6Reserve updates3.7Claim file document management3.8Legal deadlines and their control3.9Periodic communication with the policyholder3.10Practice: investigation of a typical claim file
4.1Coverage decision and its justification4.2Reasoned offer and reasoned response4.3Calculation of compensation4.4Repair in kind and service provision4.5Payment, receipts and final release4.6Rejection and communication to the policyholder4.7Reopening and its causes4.8Recovery and subrogation4.9Claim closure and release of reserves4.10Practice: settlement and communication of a case
5.1Sample-based claim file review5.2Indicators for timescale, cost and quality5.3Queue and aged file management5.4Complaints management5.5Team training and calibration5.6Automation of repetitive tasks5.7Coordination with underwriting and product5.8Reporting to management5.9Continuous process improvement5.10Practice: process dashboard
6.1Choice of line of business and scope6.2Detailed map of the current process6.3Diagnosis of critical points6.4Redesign of the proposed process6.5Protocols for each phase6.6Indicator and control system6.7Team training plan6.8Implementation plan6.9Project report6.10Project defence
How you'll learn
100 % online training on the SEIUM campus, with downloadable material, recorded classes and an assigned technical tutor. No fixed timetables: students progress at their own pace within the intake, making it possible to combine with work.
Each module combines theory, guided reading of the original standard and applied exercises. The working software is Guidewire ClaimCenter, Microsoft Excel, Bizagi Modeler, Power BI, in free, academic or evaluation versions. Tests are studied through real claim-file simulation procedures, BPMN process mapping and claims-handling quality audits. Assessment is continuous by module, plus the final integrative project.
Build it end to end
Your final project follows the real engineering workflow, step by step, reviewed by your tutor.
Describe the phases of the claims management process.
Carry out the opening and initial coverage analysis.
Build the claim file with the necessary documentation and evidence.
Settle and pay the claim in compliance with legal deadlines.
Apply quality controls and complaints management.
Where this takes you
Requirements
- No prior qualification required.
- Internet connection and a computer capable of running the programme's software.
- Sufficient level of Spanish to follow technical regulatory texts.
Ready to start?
Send your application today. Our admissions team replies within 72 hours with your study plan and funding options.
Frequently asked questions
The programme totals 300 hours spread over 3 to 5 months. That is an average of 10 to 15 hours a week, compatible with a full-time job.
You work with Guidewire ClaimCenter, Microsoft Excel, Bizagi Modeler, Power BI. Free, academic or evaluation versions are used, and the tutor indicates the free alternative where one exists.
SEIUM's own diploma upon passing the continuous assessment and the integrative project. It is in-house training, not an official Ministry qualification.
Yes. Modules passed in a Course or Postgraduate Diploma in the same area count towards the advanced programme. Check the recognition policy when you enrol.
Related programmes
Course in Microinsurance Applied to Urban Transport
Online 300-hour course in microinsurance applied to urban transport. 6 modules covering the IAIS Application Paper on Inclusive Insurance (2012), Directive (EU) 2016/97 on insurance distribution…
Course in Data Analytics for Shared Mobility Insurance
300-hour online course in data analytics for shared mobility insurance. 6 modules covering Regulation (EU) 2016/679 (GDPR), Organic Law 3/2018 (LOPDGDD) and Python (pandas, scikit-learn). Assigned…
Claims Management in Urban Mobility Course
Online course of 300 hours in claims management in urban mobility. 6 modules covering Royal Legislative Decree 8/2004 (civil liability and motor vehicle insurance), Law 35/2015…
More in Insurance, Risk & Actuarial Data
All Insurance, Risk & Actuarial Data programmes → · How to apply · Fees & financing · Scholarships