Specialists in the area of Insurance fraud and the verification of insurance claims, the iVerification Academy has developed the online Professional Insurance Verifier Programme to train insurance validators, assessors and investigators.
The iVerification Academy furthermore intend to develop specific healthcare training material with an investigative twist. The development will be done by a specific subject-matter-expert (SME) with the required skill and knowledge.
In addition to the Professional Insurance Verifier Programme we also offer the following short courses
- Fire Investigation – Insurance Claim
- Scene Investigations – Accidents and Stolen Vehicles
- Claim Assessment – Theft and Burglary
- Investigative Interviewing – Insurance Claim
The Professional Insurance Verifier Programme is aimed at the following learners:
- Scholars wanting to pursue a career in the insurance industry
- Investigators (private – short-term, long-term insurance, healthcare and police)
- Desktop investigators
- Claim handlers
- Non-motor assessors
- Motor assessors or engineers
Our Facilitator(s) and Developer(s) of training material undergone the following SAQA unit standard training:
- 117871 – Facilitate learning using a variety given methodologies – NQF 5 – 10 credits
- 12138 – Conduct an organizational needs analysis – NQF 6 – 10 credits
- 15218 – Conduct an analysis to determine outcomes of learning for skills development and other purposes – NQF 6 – 4 credits
- 10299 – Design learning programmes and related learning materials – NQF 6 – 20 credits
The iVerification Academy skills training material is based on specific SAQA unit standards:
An internet search that revealed (including the South African Qualifications Authority (SAQA) website) that there is no existing training available for validators/verifiers to deal with the verification of the merits and the quantification of the more complex claims. SAQA and the National Qualifications Framework Act 67 of 2008 have various unit standards from different qualifications contributing to our requirements:
- 255854 Conduct a short term insurance loss investigation (NQF Level 5)
- 243170 Describe the investigation of fraud in short term insurance (NQF Level 5)
- 253986 Administer a case file (NQF Level 5)
- 253982 Conduct an Investigative Interview (NQF Level 5)
- 253980 Investigate a crime or incident (NQF Level 5)
- 253993 Present evidence in a court of law (NQF Level 5)
- 253978 Apply principles of law of evidence (NQF Level 5)
- 253983 Apply provisions of the Criminal Procedure Act (NQF Level 5)
- The first two unit standards form part of the qualification National Certificate: Loss Adjusting (SAQA ID 61529) – NQF Level 5 – last registration date is 30 June 2023. No providers are currently accredited to offer this qualification and it appears that the learning material for this qualification has not yet been developed.
- The last six unit standards form part of the qualification National Certificate: Resolving Crime (SAQA ID 59989) – NQF Level 5 – last achievement date is 30 June 2020. Many providers are currently accredited to offer this qualification. The issue is that this qualification does not address the training of qualified insurance validators or assessors as required by the Insurance Industry. Insurance fraud (crime) is a small portion of the total number of claims registered every year. Many of these claims need to be validated or assessed as claims (validating the policy conditions, exclusions and warranties) and not as a crime. Specialist skills are therefore required.
The Quality Council for Trades and Occupations (QCTO) is a Quality Council established in 2010 in terms of the Skills Development Act No. 97 of 1998. Its role is to oversee the design, implementation, assessment and certification of occupational qualifications, including trades, on the Occupational Qualifications Sub-Framework (OQSF). The QCTO also offers guidance to skills development providers who must be accredited by the QCTO to offer occupational qualifications.
Then there is a qualification called Occupational Certificate: Insurance Claims Administrator (Insurance Claims Assessor) – NQF Level 4 (SAQA ID 99668). The curriculum document indicates that the qualification is aimed at assessors that will be desk-bound and not field workers as per our requirement and not dealing with the complex motor vehicle and other specialist claims. No providers currently accredited to offer this qualification. IA intends to offer this qualification in future.
IA further offers our own online programme called Professional Insurance Verifier Programme consisting of various modules. It will assist the learner to develop their skills and make them eligible for employment in the insurance claims industry. This programme is not registered on the NQF as yet, registration is pending. Our programme is however recognised by recruiters.
The programme was developed in line with the unit standards and the requirements of the insurance industry and how claims should be investigated.
IA developed our own enterprise standard utilizing our skill and experience obtained through our service in the SA Police Service, Specialist Investigation Unit (SIU – Mutual and Federal Insurance) and other Insurance Investigative Units (CVU, LVD, etc.). Keep in mind that the Insurance Industry requires a certain level of checks and specific validation of facts and findings which our Programme totally caters for.
Practical skills have a huge impact on the outcome of the claims validated or verified and IA therefore made this a central aspect of the online programme. Students need to know how to apply the knowledge gained in a practical work environment to successfully validate or verify a more complex claim.