Introduction to Insurance Claims Adjusting

Welcome to the world of the insurance claims adjuster. This course introduces the insurance claims adjusting profession as it began more than a century ago, up through the latest advances in claims tools and processes, provides a detailed examination of the customary activities of an adjuster, and the importance that the role an adjuster plays in today’s society.

2 Hours Elective CE
Course ID #82441
$11.00

A Matter of Ethics

In this course you’ll learn how the ancient philosophers like Plato, Aristotle and Confucius viewed Ethics in the old world and see how their perspectives compare to new world issues and behaviors. You’ll also see if, and how, those perspectives are applied to the business and insurance industries and their roles in today’s society. Finally, you’ll have an opportunity to compare those perspectives to ethics in claims handling in a discussion of Fair and Unfair Claims Practices and some of the practical issues they present.

2 Hours Elective CE
Course ID #49429
$11.00

Strategic Claims Negotiations

This course is designed to enhances an adjuster’s skills in claims negotiation. An detailed foray into concepts and principles that have proven successful time after time over the decades will provide the tools with which to approach new claims disposition challenges.

Principles include, but are not limited to, the importance of investigation, knowledge and information, accurate evaluation of exposures, assessment of the strengths and weaknesses of one’s position, deployment of offers and demands, and numerous other tips for claims and legal practitioners.

2 Hours Elective CE
Course ID #57903
$11.00

Medicare Setasides and Claims Management

Over the past several years, the issue of Medicare Setasides has reached the ears of many insurance carriers and claims and legal practitioners, and has created confusion, uncertainty and doubt about what to do and how to do it. The objective of this course is to “set-aside” (yes, pun intended…) that confusion and uncertainty, and provide you with the means of resolving Medicare Setaside issues with confidence.

The Medicare Setaside law affects ALL types of insurance claims, i.e. auto, general and products liability, No Fault/PIP, workers’ compensation, uninsured motorist, and any other type of insured, self-insured or uninsured right of recovery to which an injured party may have access. This course will provide you with important background information and a current update on the Medicare Secondary Payers Act and how you can effectively use this information in the resolution and settlement of claims.

3 Hours Elective CE
Course ID #59490
$16.50

Residential Property Claims Adjusting

Property loss adjusting can be one of the most demanding, and yet one of the most gratifying, careers in the property and casualty insurance industry. These adjusters must possess an extremely detailed understanding of property coverages, a significant body of knowledge in property values, costs and methods of repair, and a working knowledge of accounting and construction methods and materials.

This course will take students through a detailed examination of the most commonly encountered residential dwelling and homeowners coverages, introduce them to traditional property adjustment doctrines, and present them with most of the typical claim scenarios encountered by property adjusters.

3 Hours Elective CE
Course ID #59447
$16.50

Protecting the Blown-Away Policyholder

Hurricane, tornado, and other windstorm losses often involve widespread catastrophic damage. Certainly, the management ranks of insurance companies and independent adjusting firms anticipate these catastrophes and are always prepared to send CAT teams to areas that are devastated by these widespread loss events.

Yet without a commitment to appropriate, ethical claims practices and importance of fulfilling the claims process, a timely and fair adjustment function will never properly, and in good faith, take place. This course explores Florida’s Civil Remedy Law, Unfair Claims Practices Act, and Adjuster’s Code of Ethics as they impact recommended claims practices and good faith claims handling after hurricanes and other catastrophic events.

1 Hours Elective CE
Course ID #53003
$5.50

Causation Concepts

Theories of causation have played a key role in the construction of first-party insurance contracts for nearly a century. Quite often, one event can lead to another event, and in some cases, both events are meant to be covered, while in other cases, one event is intended to be covered while the other is not. Today, the inability of policy drafters to create language that is both clear (for policyholders) and unambiguous (for the courts) relative to what is covered and what is not continues that controversy and, unfortunately, the industry’s inability to satisfy its primary customers (consumer and shareholder) has led to the formation of policy language that, on its face, can be taken as completely one-sided in favor of the insurer, thus leaving the policyholder out in the cold.

Using references to the San Francisco Earthquake and Fire of 1906, Hurricane Katrina (2005), and other examples, this course provides Adjusters and other claims professionals with an analysis of causation and how it affects coverage under traditional 1st party homeowner’s and commercial insurance policies, including the three (3) doctrines that play a role in loss determination: Proximate Cause, Concurrent Causation, Efficient Proximate Cause, and the most recent harbinger of change in the treatment of causation…The Anti-Concurrent Causation Clause

2 Hours Elective CE
Course ID #75522
$11.00

Chinese Drywall: Legal Issues, Exposure and Insurance Coverage

This course traces the odyssey of Chinese drywall through the U.S. courts and the insurance industry since its initial introduction into the American marketplace.

We will discuss the origin of the Chinese drywall problem, how it has affected businesses, industry, and consumers, the various insurance coverages triggered by this exposure, and the impact and status of litigation in the areas most affected.

2 Hours Elective CE
Course ID #748423
$11.00

Insurance Issues in Arson Investigations

This course outlines the sensitive, and often prejudicial, issues surrounding the investigation of suspected arson. Students will learn where the sensitivities are in terms of coverage, confidentiality, legality and the potential for bad faith. Practical suggestions and tips are provided to the student in order to assist in this type of investigation without prejudice or harm to policyholder, adjuster, or carrier.

1 Hours Elective CE
Course ID #50047
$5.50

Coordinating Civil & Criminal Arson Investigations

Arson is a crime. Yet it is also an absolute defense to an insurance claim when the insured has caused the fire. For both criminal and civil arson cases, a thorough investigation is the key to success. This course explores the perspectives of both the civil and criminal investigators and how their efforts can be best coordinated to achieve maximum effectiveness and the best possible outcome.

1 Hour Elective CE
Course ID #50048
$5.50

The Investigation of Fire Claims for Arson

Arson is a crime. It’s also an absolute defense to an insurance claim when the Insured caused the fire. Yet the investigation of fire claims for potential arson involves complex and extremely sensitive issues, any one of which, if not properly considered, could not only forfeit the potential for a valid defense, but could also subject the investigating parties (e.g. carrier, agent, adjuster, et al.) to both civil and criminal sanctions.

For criminal and civil arson cases, a thorough investigation is the key to confirming arson as the cause of a fire, and it begins as early as the initial application for insurance. The investigation of a criminal arson case is also subject to a set of rules which differs greatly from the rules governing a civil arson investigation. The two investigations often proceed along parallel lines, and while the lines may be closely parallel, they do not intersect because the fundamental objectives are different.

This course explores the how and the why of conducting a thorough investigation of a fire claim, from the initial application, through the potential for both civil and criminal remedies for both insured and insurer.

3 Hours Elective CE
Course ID #84857
$16.50

Introduction to Commercial Property Adjusting

Commercial property claims, on average, are more complex than homeowner’s claims due to the variety of coverages, nature and size of buildings, and greater value — and they typically take more time and effort.

Nevertheless, when handling any claim involving commercial property insurance, the treatment of perils is basically the same as that taken in the handling of dwelling and homeowner’s claims. This course introduces the property adjuster to the most common commercial coverages and adjusting concepts.

2 Hour Elective CE
Course ID #82448
$11.00

Analyzing Causation in Property Claims Adjusting

Using references to the 1906 San Francisco Earthquake & Fire and the 2005 killer storm nearly 100 years later, Hurricane Katrina, this course provides adjusters with a detailed analysis of the doctrines of causation and how they each affect coverage under traditional homeowner’s and commercial insurance policies. We will cover the three legal doctrines of causation that have historically expanded coverage for losses involving more than one peril: Proximate Cause, Concurrent Causation, and Efficient Proximate Cause. The course will also reveal the insurance industry’s latest and most effective attempt to put a stop to these expansive interpretations of coverage: The Anti-Concurrent Causation Clause.

This “new” 4-credit course expands on the concepts discussed in the popular 2-credit title, Causation Concepts, and provides adjusters a detailed description of the days and months following the 1906 San Francisco Earthquake & Fire, and an assessment of how the insurance industry of that day responded.

We hope you will take away additional understanding and appreciation for these complex issues, and that they help you on future challenging assignments.

4 Hours Elective CE
Course ID #85026
$22.00

An Update on Chinese Drywall Litigation

This course begins by tracing the odyssey of Chinese drywall through the U.S. courts and insurance industry since its introduction into the American marketplace. You will learn the origin of the Chinese drywall problem and the issues of liability, insurance coverage, and damages that have affected thousands of homeowners and the builders and suppliers of services of the residential construction industry.

Then, in an interesting update on litigation that wrestled with one of the latest and most complex property issues to hit this Continent, you will learn how the courts are ruling, and the future of Chinese Drywall claims in the areas most affected.

3 Hours Elective CE
Course ID #85036
$16.50

Automobile and Motor Vehicle Physical Damage Adjusting

In this course, students learn how to handle first party physical damage claims for damage to personal and business use automobiles commonly insured under the Personal Auto, Business Auto and Garage/Garagekeepers policies. Students will also learn traditional auto adjustment doctrines and best claims practices as they work though many of the typical claim scenarios they would encounter as an Auto PD adjuster.

2 Hours Elective CE
Course ID #59469
$11.00

The Evolution of Florida No-Fault/PIP

More than thirty years ago Florida’s current Motor Vehicle No-Fault Law was enacted as one the 20th century’ first tort reform initiatives. Despite the noble intent of this law and subsequent modifications by both the legislature and the courts, it has been abused to the point that it is now both ineffective and extremely costly to business and the general public.

In this course we will discuss the original intent of Florida’s No-Fault/PIP Law, what went wrong, address some of the legislative changes passed over the years to prevent the most common abuses of no-fault, and what the Florida legislature ultimately did in it’s attempt to rescue the system.

1 Hours Elective CE
Course ID # 53090
$5.50

Case Law Update: Impact, Spoliation, Presumptions & Seat Belts

As more and more cases are reported by the appellate courts, various areas of law and liability are defined and refined, ultimately providing the judiciary’s interpretation of “the law of the land”.

This course explores four of the more troublesome areas of law and liability typical in today’s Florida claims handling environment: The Impact Rule, Spoliation of Evidence, Presumptions of Negligence in Rear-End Auto Accidents, and Seat Belt Laws and Auto Liability.

2 Hours Elective CE
Course ID # 57951
$11.00

The Florida Automobile: A Dangerous Instrumentality

Veteran adjuster Bryce Jansen was not as disappointed as he thought he would be when the tranquility of his early morning fishing trip was interrupted by an urgent call from one of his oldest clients. What lay ahead would challenge his adjusting skills as they were focused in a direction rarely encountered in the Florida claims environment.

In a revolutionary approach to adjuster CE, this course is designed to enlighten adjusters and other claims professionals with a deeper understanding of one of Florida’s most complicated legal doctrines in automobile liability, the Dangerous Instrumentality Doctrine. The course identifies a legal authority that began in 1920 with the Florida Supreme Court and still exists today. You will learn to identify and discusses principles of liability under this unique application of the Dangerous Instrumentality Doctrine, it’s limitations, and how to the doctrine is to be applied. When finished, you will have a deeper understanding of how to investigate automobile accidents when faced with this exposure, and how to take advantage of the exceptions and defenses to the doctrine.

2 Hours Elective CE
Course ID #71636
$11.00

Business Auto Claims Handling

This course is designed to provide adjusters with a general understanding of the coverage provided under the Business Auto Coverage and provide instruction and guidance to those who are unfamiliar with business auto claims. This course is also designed to provide insight and direction on the day-to-day claim handling issues related to coverage interpretation and to address the most common coverage issues found when handling Business Auto claims.

2 Hours Elective CE
Course ID #82618
$11.00

Handling Garage Coverage Claims

A Garage Policy affords blanket coverage for operations necessary or incidental to an auto-related businesses without requiring multiple insuring agreements. This kind of policy combines the features of both Business Auto and Commercial General Liability coverage into one insuring agreement. It also provides physical damage coverage for garage autos as well as liability coverage for damage to customers’ autos while in the insureds care, custody or control.

In this course, adjusters and other claims/risk professionals will learn how to handle Garage claims by addressing the unique coverages provided under the Garage Coverage Form and that claim exposures faced by those in the automobile business.

3 Hours Elective CE
Course ID #82431
$16.50

Adjusting Garagekeepers Claims

When a customer leaves an automobile in the care of an automobile dealer or other related auto business, there’s a tremendous risk of loss if the vehicle is damaged while the business is attending, servicing, repairing, parking or storing the auto in a garage operation. Yet getting payment from the attending business can be difficult because any “legal liability” for such damage would be excluded under the liability section of other applicable policies (i.e., Business Auto, Commercial General Liability and Garage Policies) by virtue of the care, custody, or control exclusion.

Garagekeepers coverage provides protection for damage or loss to a customers’ auto left in the insured’s care. This course is specifically designed to provide adjusters and other claims/risk professionals with an understanding of this type of coverage, including valuable insight on typical claim issues they will encounter, like the application of direct coverage options, liability deductibles, work you performed, and the elements of bailment and bailee exposure.

2 Hours Elective CE
Course ID #82532
$11.00

Commercial Premises Liability

This course presents a updated overview of the law in Florida on commercial premises negligence claims, the duties owed to business invitees, and the legal standards for proving or defending liability under these laws.

Specific topics include indoor slip and falls, parking lot and outdoor accidents, falling merchandise, and negligent security.

2 Hours Elective CE
Course ID #54163
$11.00

General Insurance and Liability Laws

Never before and never again, since Edward G. Robinson’s memorable quote in the 1941 MGM film, Double Indemnity, has there been a more poignant and accurate description of the work of an adjuster. To be sure, the world of the insurance adjuster has changed in many ways, but in many ways it has not. While the term “claims man” may be obsolete, its meaning and the purpose behind the job has remained and now provides countless opportunities for men and women alike. The variety, interest and intrigue of an adjuster’s job remains the same, and, if approached professionally, still requires a broad range of knowledge, skills and talent.

Maximizing one’s effectiveness as a claims professional requires a solid understanding of the insurance industry, it’s policies, theories of civil liability, and the American Tort System. This introductory course into the world of insurance explores the underlying concepts of insurance, its policies, and theories of legal liability that ultimately call the insurance mechanism into action.

3 Hours Elective CE
Course ID #74692
$16.50

The Origin & Evolution of Workers’ Compensation

This course introduces Workers’ Compensation as an occupational benefit delivery system, explores the issues and concepts that influenced its development over the past century, and identifies the most challenging claims management issues of the day.

1 Hour Elective CE
Course ID #49436
$5.50

Florida’s Workers’ Compensation Benefits

The timely and accurate payment of workers’ compensation benefits is one of the most critical elements in the handling and management of occupational injury claims. Injured workers depend on these benefits for treatment of their injuries and replacement of lost income during periods of disability, and they may also depend on other benefits due under the various workers’ compensation laws. As such, an adjuster must understand the benefits provided under this system of laws, know how those benefits of comp compare across the various jurisdictions, know when they are due and for how long, and know exactly how much to pay.

In this course you will be introduced to the basic benefits provided under Florida’s workers’ compensation statute, the drivers behind these benefits, how they should be computed, and when they should be paid. This is a perfect training course for new adjusters, or for experienced adjusters new to Florida WC.

3 Hours Elective CE
Course ID #62304
$16.50

Florida’s PTD Benefits

This course explores Permanent Total Disability benefits as provided under Florida Workers Compensation law prior to and after the October 1, 2003 legislative changes.

Particular attention is paid to the controversies over the impact of a worker’s application and/or approval for receipt of “Social Security Disability Benefits” as criteria for PTD status prior to and after the 2003 legislation.

2 Hours Elective CE
Course ID #49435
$11.00

The Compensability of Workers’ Compensation

Knowing the laws of workers’ compensation is only the first step on the road to becoming a successful claims adjuster or case manager. Those who handle workers’ compensation claims should know the legal doctrines that form the basis of these laws and understand the “why” behind the laws if they wish accurately predict the outcomes of adversity.

This course provides a comprehensive identification and analysis of the legal doctrines most commonly faced when compensability is questioned, the facts that count most in a factual investigation, and how these compensability issues will most likely be resolved in the courts.

3 Hours Elective CE
Course ID #54292
$16.50

Deciding Compensability, Part I: Jurisdiction, Notice and Employment

This course explores numerous issues surrounding the administration of workers’ compensation benefits that arise prior to and immediately following the actual receipt and handling of a claim. Get to know how issues of jurisdiction, choice of laws, notice of injury or claim, delayed reporting, statutes of limitation, employee vs. independent contractor issues, and when employment begins and ends impacts the compensability (or lack thereof) of a claim.

After taking this course, you’ll never look at another comp claim in the same way, and you’ll be amazed at the increase in confidence you’ll have in the decisions you make.

1 Hours Elective CE
Course ID #53482
$5.50

Deciding Compensability, Part II: The Legal Doctrines of Workers’ Compensation

Knowing the laws of workers’ compensation is only the first step on the road to becoming a successful claims adjuster or case manager. Skilled claims and medical professionals who handle workers’ compensation claims know the legal doctrines that form the basis of these laws and understand the “why” behind the laws. This course examines most common legal doctrines that arise in the investigation and analysis of compensability.

After taking this course, you’ll be amazed at how easy compensability decisions will become, and the level of confidence you’ll have in making them.

2 Hours Elective CE
Course ID #54006
$11.00

The Economics of Workers’ Compensation

This course is designed to enlighten adjusters and other claims professionals with a deeper understanding of one of the most basic, yet most critical of functions that lie just outside the realm of claims handling — the underwriting process — and the impact that claims handling, particularly in the areas of evaluation and reserving, have on workers’ compensation insurers and employer premiums, profitability, and loss.

The course reveals the interdependencies that exist between each of these disciplines, and helps the workers’ compensation claims professional better understand how reserving impacts rating, risk analysis, acceptance and pricing of insurance. When finished, students will have a deeper understanding of how each step taken in the evaluation and reserving process impacts the financial fates of insurers and their customers.

2 Hours Elective CE
Course ID #62623
$11.00

Evaluating and Reserving Workers’ Compensation Claims, Part 1: Finding the Value

Do you know the difference between “case reserves” and “bulk reserves”? How about “incurred” vs. “paid” reserves? One of the most important risk management and fiscal control tools in the field of workers’ compensation is the reserving of claims.

Accurate and credible financial claims data is the only sure way to measure performance in loss control and safety, and it is critical for accurate financial reporting to regulators and other stakeholders. This course presents a discussion of individual claim evaluation theory and practice as a method of estimating the ultimate probable cost of a claim, and the concept of reserving as a projection of financial loss.

2 Hours Elective CE
Course ID #51211
$11.00

Evaluating and Reserving W/C Claims, Part 2: Presenting Your Case

The ability to forecast, or evaluate, the ultimate cost of a claim comes from training and experience, and is more art than science. The experienced claims professional who engages in these best claims practice evaluation and reserving techniques follows consistent practices and protocols, not only in the calculation of future exposures but also in their rationalization and documentation.

In this follow-up to the Evaluation and Reserving of W/C Claims, Part 1: Calculating Your Exposures, you will learn to apply best practice protocols to explain and document your evaluation of workers’ compensation claim exposures.

2 Hours Elective CE
Course ID #54282
$11.00

The Intoxication Defense

The Intoxication Defense has long been regarded as one of the strongest, yet often most misunderstood defenses against a workers’ compensation claim.

While the increasing prevalence of alcohol and drug use in our society has also increased the attention to the issue of alcohol and/or drug involvement in the workplace, all too often the defense is misused and benefits are either wrongly denied, or valid defenses compromised. This course examines Intoxication Defense in multiple jurisdictions across the country, including California, Florida, Georgia, North Carolina, Texas and more.

1 Hour Elective CE
Course ID #50545
$5.50

Subrogating Work Comp in Florida

Veteran adjuster Bryce Jansen had rarely seen anyone so catastrophically injured. Young Nick Chambers would never walk again, and he would be lucky to live another 10 years. Bryce had sworn that he would find and pursue the 18-wheeler that had forced Nick off the road. Even though the work comp lien was ultimately expected to near $10 Million, a successful civil case could net twice that much and leave poor Nick with something to make his remaining years at least a little more comfortable.

In this revolutionary approach to adjuster CE, you’ll learn about the investigation, pursuit, negotiation, and recovery of workers’ compensation liens under Florida’s Manfredo Doctrine. See how principles of liability, their defenses, and the identification of those who might be responsible for occupational injury, can ultimately result in recovery for individuals or businesses who must suffer under the burdens of workers’ compensation.

3 Hours Elective CE
Course ID # 71339
$16.50

Employers’ Liability and Coverage B: Claims of a Different Color

The liability of employers to injured workers for workers’ compensation benefits is nearly a century old, and while continually evolving, is accepted as part of the status quo in all states. More controversial, however, is the liability of an employer outside the laws of workers’ compensation.

This course examines some of the exposures of Employers Liability and the insurance coverages “B” that typically respond to them.

1 Hour Elective CE
Course ID #54007
$5.50

Overview of Longshore & Harborworkers’ Compensation Act

Despite their widespread existence, state workers’ compensation laws do not apply to everyone. People who work on or around navigable waterways, in maritime commerce, or in the repair and maintenance of ships, wharves, piers and docks are usually covered by various federal laws. This course provides an overview of our nation’s most significant employment exposures: The Longshore & Harborworkers Compensation Act.

2 Hours Elective CE
Course ID #55107
$11.00