Course Modules

Module 1: Introduction to Cash Settlement Standards

• Types of claims and settlement categories

• Regulatory frameworks and insurance guidelines

• Roles and responsibilities in claims settlement

• Documentation basics and required forms

• Case study: Common settlement processing challenges

Module 2: Claims Evaluation, Liability Assessment and Documentation

• Reviewing claim submissions and supporting evidence

• Determining liability and coverage

• Calculating settlement amounts and valuing losses

• Using claims handling systems and digital records

• Exercise: Create a comprehensive claim assessment checklist

Module 3: Cash Settlement Procedures, Approval Processes and Controls

• Verification and validation of claim information

• Approvals, authorization levels, and workflows

• Internal controls for cash settlement transactions

• Preventing overpayments and duplicate settlements

• Activity: Simulate settlement authorization procedures

Module 4: Negotiation, Dispute Resolution and Customer Communication

• Managing disputed claims professionally

• Negotiation techniques for settlement agreements

• Communicating decisions clearly and respectfully

• Handling difficult conversations with claimants

• Role play: Conduct a settlement negotiation scenario

Module 5: Fraud Detection, Red Flags and Ethical Claims Handling

• Spotting fraudulent documentation

• Behavioral indicators and suspicious claim patterns

• Ethical decision-making in settlement processes

• Reporting fraud and escalation procedures

• Simulation: Investigate a potential fraudulent claim