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.
Take the controls.
Run a real engineering trade-off from this programme. 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.
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