Accident and Disability Insurance is far more affordable with lower premium for large sum assured if compared to life/health premium. This fact alone makes accident and disability claims more amenable to fraud and abuse. Disability Claims are common claims made under Accident Insurance policy, often includes a high share of suspicious claims - claiming disease related disability as trauma-related disability. Disability claims are also commonly seen in motor 3rd party liability, where the payouts can be very high (commensurate with income loss of the injured).
This course will help you understand what is disability, different types of disability, establishing admissibility of disability claim by drawing a path from alleged injury to final disability, scrutinizing genuineness of disability certificate submitted; and disability benefits claimed. You will also discover the challenges in calculating rational percentage of disability in cases of permanent partial disability and how it is a major cost benefit exercise to the empowered.
Key Learning Outcome:
At the end of the course, participants will be able to:
- Rationally evaluate a claim of disability – interim and final
- Challenge a non rational disability certificate
- Reconstruct an accident to assess alleged disability
- What injuries can lead to different type of disabilities?
- Is this case a true disability?
- What is disability? Types of disability – TTD, TPD, PPD.
- Evaluating veracity of disability certificate submitted.
- Reconstructing a path from alleged injury to final disability and establish validity of claim with detailed scrutiny of sequential documents eliciting treatment taken throughout the period before fitness/ PPD certificate; especially speech, auditory and ophthalmic disability.
- Calculation of disability percentage according to the Act 685 of Laws of Malaysia – Persons with Disabilities Act 2008 (reprint 2018), or another ASEAN country.
- Life, Health and CI Underwriters
- Claims personnel in Life, Health, CI, Accident, Motor liability and Disability
Dr C H Asrani
DNB (Family medicine); PGD Medicolegal Systems; Adv. Dip in Forensic Medicine & Toxicology
CEO, Founder – INCHES’ group of companies
Dr C H Asrani has over four decades of active clinical practice and over two decades of experience in insurance consulting and training insurance professionals (underwriting and claims for both life and health insurance). A renowned expert in this area, Dr Asrani pioneered medical audit in insurance in India. With over 300 presentations in insurance risk management, Dr Asrani has been training across Dubai, Bangkok, Kuala Lumpur and Singapore. He also has the distinction of being associated with the National Health Authority (Ayushman Bharat scheme), consulting with The World Bank and being a panelist on various talks on monitoring, audit, and fraud surveillance in the Insurance industry. He is also one of the first medico entrepreneur to devise cloud-based fraud prevention solutions for insurance companies in India (www.inches-insuretech.com). He is now on an expansion drive to extend his company’s service innovative solutions internationally. The solutions include medical insights for underwriting, rational claim adjudication, medical processes architecture, clinical audit of claims & underwriter / claim assessor trainings. Dr Asrani’s group of companies have also developed Intelli-Claims, a proprietary tool for medical adjudication of claims using standard treatment guidelines and rule-based analytics.
Date and Time
Date: 6 - 7 July 2021
Time: 9.30 a.m. - 12.30 p.m.
Registration Closing Date: 29 June 2021
Early Bird (Register before 18th June 2021)
RM 550 (single), RM 500 (Group)
RM 750 (Single), RM 700(Group)
USD200 (Single), USD180 (Group)
RM 650 (single), RM 600 (Group)
RM 850 (Single), RM 800(Group)
USD220 (Single), USD200 (Group)