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Claims Practice (M85) considers the practical aspects of handling a claim; from receipt to settlement (whatever that means in each case). It deals with the rules within which the claims handler must operate, as well as explain those of their duties which do not relate directly to the customer, e.g. the setting of claims reserves and ensuring that reinsurance and other recoveries are made.
Not all claims arise directly from the insurer's own policyholder. Some will come from persons, third parties, who have a problem with the policyholder, having experienced a loss because of their actions. We will see the law behind such claims and how to settle them. Some of these claims may end up being dealt with in a court of law. Consequently, they must be dealt with in a certain way to comply with the law and court procedures and this study text explains this.
Finally, we will look at what to do when a customer is not satisfied with how their claim has been resolved, what rules apply and the techniques of dispute resolution.
Building a successful career in insurance
This course is ideal for claims handlers and for those looking to gain knowledge and understanding of claims practice. Claims Practice (M85) counts towards a Diploma in Insurance. It may also count towards the Advanced Diploma in Insurance.
Please note it is assumed that you already have knowledge of the fundamental principles of insurance as covered in Insurance, Legal and Regulatory (IF1) or equivalent examinations.
Summary of learning outcomes
Assessment
Units treated as equivalent
Due to the extent of syllabus overlap, certain combinations of current and withdrawn units will result in only one award of credits.
If a withdrawn equivalent is held you may not need to complete a current unit in order to satisfy a qualification's completion rules. Clarification should always be sought from CII Customer Service.
Find out more about credit awards for equivalent units
Course delivery
Instructions on accessing your course on RevisionMate will be sent to your registered email address. This is typically within two working days of your order being placed, but may be longer, particularly if payment is made by bank transfer or the unit is available as a pre-order.
Study material - editions available
2023-24 edition (applicable to exams sat 01 May 2023 to 30 April 2024)
Revision aids available
The revision aids available for this unit are listed below. You can find more details about these here.
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These updates are Learning Solutions updates for study purposes.
2025-26 edition
To view a list of the main areas of change in the 2025-26 edition, please click here
2024-25 edition
To view a list of the main areas of change in the 2024-25 edition, please click here
Study text updates:
M85_2024-25_web_update_1_30-05-2024
Testing Position
Financial Ombudsman Service Award Limit Change
Changes to the Financial Ombudsman Service (FOS) award limits come into effect on 1 April 2024. Examinations will be reflective of these changes from 1 July 2024.
The M85 Examination Guide for exams from 1 May 2023 to 30 April 2024 was first published in February 2023. Any questions which have been amended since the examination guide was first published will appear below.
Question 2 - Amended 27.06.2023