chapter  1  How Insurance Companies  Process Claims

Chapter 2  Successfully  Moving  the case  Through the claims Office  

Chapter 3   Aspects of Claims Frequently   Questioned by Adjuster

Chapter 4  Understanding How  reserves are set  by insurance Companies

Chapter 5  Understanding How Insurance Companies  Value claims 

Chapter 6  Determining  and proving  Economic damage / defense

Chapter  7  How defense Counsel  Value Claims 

Chapter 8    How Reserved Are Established

Chapter  9  Proving/ disproving  Pain and Suffering

Chapter 10  Understanding and Handling Preexisting  injuries

Chapter  11   Proving /Disproving  Hedonic Damages

Chapter  12    Evaluating Coverage 

Chapter  13   Determining  Coverage  and Obtaining Policy Limits 

Chapter 14  What to do When Liability is Denied

Chapter 15   Documenting  Claims

Chapter 16   How   Adjusters  Settle  Claims

Chapter 17 Chiropractic Treatment  In Soft Tissue Injury Cases

Chapter 18  Guide to Obtaining  Medical Recodes

Chapter 19 Common Mistakes  Made By  Attorney and Adjusters in documenting Claims 

Chapter 20  Maximizing/Minimizing   Damages in Small Personal Injury Cases

Chapter 21  Negotiating with Insurance Adjusters and Attorneys

Chapter 22  What are  The elements of Bad faith

Chapter 23   How to negotiate  with  Insurance companies/ Attorney to  bring closure  

Chapter 24  Medical  Terminology/ Anatomy 

Chapter 25   Medical Record Review  and CPT  Coding

Chapter  26  Evaluating Settlement Offers 

Chapter 27  Structured Settlement  Opportunities, Problems and Benefits

Chapter 28   Appraisal Of Insurance Claims 

Chapter  29  Solving  Common Settlement  Problems

Chapter  30  Evaluation of Soft Tissue Injuries

Chapter 31  Evaluating  and Settling Medical  Mal Practice claims 

Chapter 32 Settling  Auto  Accidents Cases

Chapter 33   Avoiding  and Resolving  Weak Cases 

Introduction

Chapter 1 Representing The Policy Holder

Chapter 2 Trigger Of Coverage

Chapter 3 Extent Of Coverage

Chapter 4. Duty To Defend

1. Typical Defense Provisions
2. Extent of Insurer's Defense Obligations
3. Trigger the Insurer's Defense Obligations
4. Claim Involving Multiple Bases for recovery
5. Administrative Claims
6. Excess Insurers

Defense Rights and Duties

1. Insurer

1. Duty to investigate

2. Providing a defense and payment of defense cost .

3. Defense costs defined

4. Policy Limits

5. Allocation of Defense Cost

6. Insurer's Right to Control the Defense

1. Insured

When the insurer May Discontinue Defense

1. Generally

2. Insurer's Obligation to appeal

3. Insurer's Recovery of advanced Defense Cost

Refusal to provide a defense

1. waiver of Rights

2. Change of Mind After Refusal to Defend

3. Action Against an Insurer

Chapter 5. Legally Obligated To Pay Damages

Chapter 6. Intentionally Issues

Chapter 7 Property Damages And Bodily Injury Personal

Chapter 8 Injury And Advertisement Injury

Chapter 9 Contractual Liability

Chapter 10 Exclusions

Chapter 11 Directors and Officers Liability Insurance

Chapter 12 Other Specialty Liability Policies

Chapter 13 General Coverage

Chapter 14 Boiler And Machinery Coverage

Chapter 15 Fidelity Coverage

Chapter 16 Other First Party Coverages

Transportation Related Policies

Chapter 17 Marine Insurance

Chapter 18 Aviation Insurance

Chapter 19 Contract Formation and Related Underwriting Issues

Chapter 20 Interpretation of Policies

Chapter 21  Assignment , Transactions and Successorship

Chapter 22 Insolvency

Chapter 23 The London Market

Chapter 24 Claims Handling overview

Chapter 26 Litigation Of Insurance Coverage Disputes

Chapter 1 Introduction

Chapter 2 Negligence

1. Introduction
2. Duty/Privity
3. Standard of Care
4. Res Ispa Loquitur

Chapter 3 Misrepresentation

Chapter 4 Warranty

1. introduction
2. Express Warranty
3. Implied Warranty of Merchantability
4. Implied warranty of fitness for a particular purpose
5. Persons Who are protected : Privity of contract
6. Remedies
7. Limitations on liability : Disclaimers , Damages Limitations Time limitations , and notices

Chapter 5. Emergence of Strict Tort Liability

1. Adoption
2. Policies Underlying Strict Liability
3. Other Approaches

Chapter 6 Fundamental Principles of strict liability: Basic Test of defects

1. Consumer expectations
2. Risk _ Utility
3. Other Approaches

Chapter 7 Fundamental principles of strict liability Changes in technology and knowledge of risk

1. Ignorance of Generic Risk
2. Changes in Technology
3. Unavoidably Unsafe Product
4. Ignorance of Risk caused by Misuse

Chapter 8 Fundamental Principles of Strict Liability: Effects of Statues and regulations

Chapter 9 Application of Principles

1. Manufacturing Flaws
2. Design Defects
3. Failure to Warn

Chapter 10 Proof of Defects

1. Industry Standards and customs
2. Tracing a defect to the defendants
3. Post _ accident Remedial Measures
4. Expert Witnesses
5. Other methods of proof

Chapter 11 Causation in Fact

1. tests for Determining Causation
2. Proof of causation

1. Proximate Cause
2. Categorical Rules Restricting Recovery

Chapter 13 Punitive Damages

Chapter 15 Consumer conduct Defenses and Comparative fault.

1. Assumption of Risk
2. Product Misuse
3. Contributory Negligence and Comparative Fault

Chapter 16 Statues of limitations and Repose

Chapter 17 Parties and Transactions Governed by Strict Liability

1. Parties who can be sued
2. Transactions Covered by Strict Tort Liability and warranty

Chapter 1 Admiralty  Jurisdiction.  Chapter 2 Federalism  and Admiralty . Chapter 3  Admiralty and the General Maritime Law .

Chapter 4  Protection And Welfare, Employment Related Injuries, The Jones Act,  Unseaworthiness, Maintenance, Cure and Unearned Wages.

Chapter 5 Longshore and Harbor  Workers . Chapter 6  Wrongful Death . 

There are 39 areas to cover in this course. The course  takes s for 26 weeks to cover all material:  There are 10 essay which the student must pass to receive a professional Hospital Risk Management Designation  ICCHRM

This course is designed for risk managers and medical staff  in the hospital environment .  

 The cost of the course is $1,300.00 plus books

1. Introduction to Risk Management.
2. Risk management in managed care.
3. The Risk manager's role in the integrated delivery system.
4. Integrating Risk management, utilization management and quality management: Maximizing benefits through integration.
5. Incorporating quality improvement strategies and benchmarking into risk management .
6. Benchmarking in risk management.
7. Risk management strategic planning for a changed health care delivery system
8. Developing tools to identify and manage the risk of managed care.
9. Setting up a risk management department.
10. Understanding the need for a corporate compliance program.
11. Developing a risk management manual.
12. Risk management program development
13. The risk manager's responsibility for off- premises locations.
14. Managing the data needs of managed care .
15. Education as a valuable risk management tool .
16. Consent issues in the medical environment.
17. A basic insurance primer.
18. Understanding provider excess and stop- loss insurance
19. Self-Insurance for physicians/surgeons and how to protect hospital interest allowing physician to become self-insured.
20. Insurance products to minimize financial risk of managed care.
21. Risk financing: an important risk management function.
22. Risk financing issues facing medical providers.
23. Guidelines for in- house claims management.
24. Risk management issues associated with Anesthesia.
25. Developing a comprehensive risk management program in obstetrics.
26. Risk management issue in the emergency department.
27. Risk management in the pediatric settling.
28. Risk management in the psychiatric settling.
29. Managing the risk associated with clinical research.
30. Managing the risk associated with telemedicine.
31. Managing the risk of home health care .
32. Legal issues associated with the use and development of practice guidelines.
33. Managing the risk of workers compensation.
34. Credentialing issues and managed care.
35. The physician as Gatekeeper- what are the risks .
36. Ethics, accreditation, and managed care: a guide for risk managers .
37. Legislative and regulatory issues.
38. Cobra risk and managed care .
39. Managed care contracting.

	START		ORGANIZATIONS
	INTRODUCTION		TYPE OF SERVICES
	PERSONNEL		SEMINAR
	RESPONSE FORM		RISK PROFILE
	EMPLOYMENT		PRODUCTS OFFERED
	END		LINKS UNDER ICC