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Master’s in Operations & Claims Engineering

Online master's programme of 1,900 hours in insurance operations and claims engineering: 12 modules covering insurer operations, the claims life cycle, operational excellence, automation and AI, loss adjusting and supplier networks, claims analytics, claims reserving, fraud and control, customer experience, complex and catastrophe claims and operations technology, with an assigned technical tutor.

Duration1900 h
ModeOnline
LanguageEnglish
Start datesSet by the faculty
AwardSEIUM Institute diploma
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Learning outcomes

What you will be able to do

01

Analyse the operational value chain of an insurer.

02

Manage the full claims life cycle efficiently.

03

Apply Lean and Six Sigma to insurance processes.

04

Implement automation and artificial intelligence in operations.

05

Develop advanced claims analytics.

06

Improve the customer experience during the claim.

07

Plan the technological transformation of operations.

Profile

Who it's for

  • Insurance operations managers.
  • Claims handlers and claims managers.
  • Claims analysts working with data and indicators.
  • Supplier network managers in insurers and assistance companies.
  • Process automation specialists.
  • Operational transformation consultants.
  • Engineering or science graduates seeking to enter the insurance sector.
Standards & tools

What you'll work with

  • Law 50/1980 (Spanish Insurance Contract Law)
  • Order ECO/734/2004 (customer service departments and services)
  • Directive 2009/138/EC (Solvency II)
  • Regulation (EU) 2016/679 (GDPR, data protection)
  • Royal Decree 1060/2015 (ROSSEAR, insurance supervision and solvency regulation)
  • ISO 9001:2015 (quality management systems)
  • Regulation (EU) 2022/2554 (DORA, digital operational resilience)
  • Guidewire ClaimCenter
  • UiPath
  • Celonis
  • Power BI
  • Python
Syllabus

12 modules · 1900 h

  1. 1.1Operational value chain
  2. 1.2Policy issuance and administration
  3. 1.3Collections and premium receipt management
  4. 1.4Customer service
  5. 1.5Claims management as a core process
  6. 1.6Operating models and outsourcing
  7. 1.7Operational indicators
  8. 1.8Operating costs and expense ratio
  9. 1.9Operational benchmarking
  10. 1.10Case study: process map of a home insurer
  1. 2.1Claim reporting and first notification of loss (FNOL)
  2. 2.2Opening and coverage verification
  3. 2.3Assignment and segmentation
  4. 2.4Loss adjusting and valuation
  5. 2.5Case reserves
  6. 2.6Settlement and payment
  7. 2.7Recoveries and subrogation
  8. 2.8Closure and reopening
  9. 2.9Customer experience during the claim
  10. 2.10Practical exercise: flow diagram of a motor claim
  1. 3.1Lean applied to insurance
  2. 3.2Six Sigma and variability reduction
  3. 3.3Value stream mapping
  4. 3.4Business process management (BPM)
  5. 3.5BPMN notation
  6. 3.6Measuring times and capacities
  7. 3.7Queue and workload management
  8. 3.8Kaizen continuous improvement
  9. 3.9Visual management
  10. 3.10Workshop: value stream map of claims settlement
  1. 4.1Robotic process automation (RPA)
  2. 4.2Intelligent document processing
  3. 4.3Chatbots and virtual assistants
  4. 4.4Generative AI in customer service and claims
  5. 4.5Automatic settlement of simple claims
  6. 4.6Computer vision in loss adjusting
  7. 4.7Workflow orchestration
  8. 4.8Risks of automation
  9. 4.9Governance of operational AI
  10. 4.10Lab: automatic data extraction from claim forms
  1. 5.1On-site and remote loss adjusting models
  2. 5.2Video loss adjusting
  3. 5.3Repairer networks
  4. 5.4Approved garages
  5. 5.5Management of assistance providers
  6. 5.6Service level agreements
  7. 5.7Repair cost control
  8. 5.8Supplier quality
  9. 5.9Customer satisfaction with suppliers
  10. 5.10Case study: redesigning a home repairer network
  1. 6.1Claims data and its quality
  2. 6.2Key claims indicators
  3. 6.3Segmenting claims by complexity
  4. 6.4Early severity models
  5. 6.5Litigation prediction
  6. 6.6Duration models
  7. 6.7Leakage detection
  8. 6.8Text analytics on claim files
  9. 6.9Claims dashboards
  10. 6.10Practical exercise: early severity prediction model
  1. 7.1Case reserves versus technical provisions
  2. 7.2Case reserving methods
  3. 7.3Reserve adequacy
  4. 7.4Claims inflation
  5. 7.5Long-tail claims
  6. 7.6Impact on IFRS 17
  7. 7.7Coordination with the actuarial function
  8. 7.8Development indicators
  9. 7.9Financial controls
  10. 7.10Case study: case reserve adequacy analysis
  1. 8.1Fraud indicators in operations
  2. 8.2Alert systems
  3. 8.3Special investigation unit
  4. 8.4Internal control over payments
  5. 8.5Segregation of duties
  6. 8.6Claims audit
  7. 8.7Internal fraud
  8. 8.8Anti-money laundering in payments
  9. 8.9Compliance in claims
  10. 8.10Workshop: control matrix for a payments process
  1. 9.1Customer journey during the claim
  2. 9.2Measurement: NPS, CSAT and CES
  3. 9.3Omnichannel
  4. 9.4Proactive communication
  5. 9.5Digital self-service
  6. 9.6Managing vulnerable customers
  7. 9.7Complaints management
  8. 9.8Service design
  9. 9.9Customer-centric culture
  10. 9.10Practical exercise: redesigning the customer journey for a home claim
  1. 10.1Large industrial claims
  2. 10.2Liability claims
  3. 10.3Serious injuries
  4. 10.4Managing catastrophe events
  5. 10.5Capacity plans for peaks
  6. 10.6Coordination with reinsurers
  7. 10.7Litigation management
  8. 10.8External lawyers and experts
  9. 10.9Crisis communication
  10. 10.10Case study: operational plan after a storm
  1. 11.1Core claims systems
  2. 11.2Policy platforms
  3. 11.3API integration
  4. 11.4Cloud architectures
  5. 11.5Insurtech ecosystems
  6. 11.6Real-time data
  7. 11.7Technology vendor selection
  8. 11.8Managing transformation projects
  9. 11.9Operational cybersecurity
  10. 11.10Practical exercise: requirements for a new claims system
  1. 12.1Operational diagnosis
  2. 12.2Process data analysis
  3. 12.3Identification of opportunities
  4. 12.4Design of the target process
  5. 12.5Technology proposal
  6. 12.6Change management plan
  7. 12.7Business case
  8. 12.8Conclusions
  9. 12.9Master's Thesis report
  10. 12.10Master's Thesis: defence before a panel
Methodology, software & labs

How you'll learn

100% online training on the SEIUM campus, with downloadable material, recorded classes and an assigned technical tutor. No fixed timetables: you progress at your own pace within the intake, so it fits around your job.

Each module combines theory, guided reading of the original regulations and applied exercises. The working software is Guidewire ClaimCenter, UiPath, Celonis, Power BI and Python, in free, academic or evaluation versions. Exercises are based on real procedures: redesigning claims processes with Lean and BPMN, automating claims document management, and severity and leakage analytics. Assessment is continuous by module, plus the final Master's Thesis.

Standards covered: Law 50/1980 on Insurance Contracts, Order ECO/734/2004 on customer service departments, Directive 2009/138/EC (Solvency II), Regulation (EU) 2016/679 (GDPR), Royal Decree 1060/2015 (ROSSEAR), ISO 9001:2015, Regulation (EU) 2022/2554 (DORA).

Assigned technical tutor:every module ends with a deliverable that your tutor marks individually.
Standards-based learning:guided reading of Law 50/1980, Order ECO/734/2004, Solvency II and ISO 9001:2015 applied to real cases, not as a theoretical annex.
Industry software:Guidewire ClaimCenter, UiPath, Celonis, Power BI and Python, in free, academic or evaluation versions.
Master's Thesis with defence:An operations and claims transformation plan for an insurer, from diagnosis to business case, defended before a panel.
Flexible format:100% online, no fixed timetables, compatible with full-time work.
Capstone project

Build it end to end

Your final project follows the real engineering workflow, step by step, reviewed by your tutor.

Operational diagnosis
Diagnose an insurer's operations and analyse its process data.
Target process design
Identify opportunities and design the target claims process with Lean and BPMN.
Technology proposal
Propose automation, AI and systems to support the target process.
Change plan and business case
Build the change management plan and the business case for the transformation.
Master's Thesis
An operations and claims transformation plan for an insurer, defended before a panel.
Career opportunities

Where this takes you

Insurance operations managerClaims managerClaims analystSupplier network managerProcess automation specialistOperational transformation consultant
Admissions & scholarships

Requirements

  • University degree in engineering, science or architecture, or equivalent demonstrable professional experience.
  • Internet connection and a computer capable of running the programme software.
  • English sufficient to read technical standards.

Ready to start?

Send your application today. Our admissions team replies within 72 hours with your study plan and funding options.

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FAQ

Frequently asked questions

The programme totals 1,900 hours over 12–14 months. You set your own pace within each intake, and your tutor helps you plan the workload around your job.

You work with Guidewire ClaimCenter, UiPath, Celonis, Power BI and Python, using free, academic or evaluation versions. Your tutor indicates the free alternative wherever one exists.

A SEIUM Institute diploma, awarded on passing the continuous assessment and the Master's Thesis. It is SEIUM's own qualification, not an official state degree; its recognition depends on the programme completed and the regulations of each country.

Yes. Modules passed in a course or postgraduate diploma in the same area are recognised in the higher programme. Ask about the recognition policy when you enrol.

A degree in engineering, science or architecture (or equivalent professional experience), a computer able to run the programme software, and English sufficient to read technical standards.

Start dates are set by SEIUM's faculty for each intake. Our admissions team will confirm the next available date when you apply.

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