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Barry Zalma, Consultant and Expert Witness
A practicing lawyer and CFE with more than 42 years experience of insurance coverage and claims handling, author of "The Insurance Fraud Deskbook" and numerous eBooks on insurance and fraud
This instructor has 40 courses »To Access This Course:
This course explains that the scope of loss, statement of loss and proof of loss are essential to the investigation and settlement of a first-party property claim. These are the documents that are essential to every claims investigation. The claim starts with the agreed scope of loss and ends with the adjuster’s preparation of the statement of loss, which allows him or her to agree with the insured as to the amount to be stated on the proof of loss.
The course covers the following:
- How a claim is adjusted.
- The obligations of the insured to the insurer to agree on a scope of loss.
- The obligation of the adjuster to take the scope of loss and value all of the damage.
- The obligation of the insurer to review and analyze relevant documents.
- The need for the adjuster to prepare a statement of loss to summarize the findings about coverage and the extent of loss.
- The use of the statement of loss to reach agreement with the insured as to the amount of loss and claim.
- That after agreement is reached a sworn proof of loss is prepared for the signature of the insure after which payment follows.
Learning Objectives
- The student will learn about the how a claim is resolved by an insurance professional.
- The student will be able to:
- Explore the work of the adjuster as they combine efforts to reach a scope of loss.
- Explore the various methods used by an insurance claim professional to resolve a claim.
- Identify what a scope of loss, statement of loss and proof of loss are.
- Explore the obligations of the insured to assist in the processing of a claim.
- Identify how the claims professional works to resolve a claim by preparation of a scope of loss and proof of loss.
- Identify how an insurer uses the scope, statement and proofs of loss determines the amount of loss compensable under a policy.
Last updated/reviewed: November 16, 2020
Included In Certifications
This course is included in the following Certification Programs:
16 CoursesCorporate Property Insurance Certification
- Introduction: Excellence in Claims Handling
- How to Acquire a First-Party Property Insurance Policy
- How to Read and Understand an Insurance Policy
- The Necessity of an Honest and Complete Insurance Application
- The Basics of the Law of Contracts for the Insurance Professional
- Ethics for the Insurance Professional
- What is the Problem with Fraud?
- Interviewing Techniques for the Insurance Professional
- Investigation of a First-Party Property Insurance Claim
- The Creation of a Scope, Statement, and Proof of Loss
- The Duties of an Insured Presenting a First-Party Property Claim
- The Insurance Examination under Oath (EUO)
- Insurance Fraud Prevention
- Compliance with Special Investigation Unit Regulations
- Compliance with Good Faith Settlement Practices Regulations
- The Obligations of a Public Insurance Adjuster
Prerequisites
Course Complexity: Intermediate
No Advanced Preparation or Prerequisites are needed for this course. However, it is recommended to take the other courses in the series prior to completing this one.
Education Provider Information
Company:
Illumeo, Inc., 75 East Santa Clara St., Suite 1215, San Jose, CA 95113
Contact:
For more information regarding this course, including complaint and cancellation policies, please contact our offices at (408) 400- 3993 or send an e-mail to .