A single denied claim or an unexpected hospital bill can turn a family's finances upside down overnight — which is exactly why health insurance exists. Policies vary widely: some are short-term with defined coverage windows, others sit as standalone plans or as add-ons to life insurance, and benefits shift depending on duration and the insured's age. Reading the fine print matters as much as having coverage at all.

This Training Course on Managing Comprehensive Medical Insurance Programs by the Arab British Fellowship Training Academy goes beyond the basics, giving participants the tools to design insurance programs, manage contract planning, calculate premiums accurately, and recognize and respond to fraud and common administrative pitfalls in medical insurance.

Who Should Attend?

• Managers responsible for insurance or social insurance functions.
• Medical insurance department staff at insurance companies and service providers.
• Employees working in medical insurance departments across any type of institution.

Program Objectives

• Introduce participants to the types of medical insurance and the standards used to manage it.
• Build familiarity with healthcare providers, the medical network, and available coverage options.
• Develop skills in managing policy issuance, claims, and medical insurance files.
• Cover contract renewal negotiation and medical insurance correspondence.
• Manage medical expenses, premiums, and financing effectively.

Module 1: Foundations of Health Insurance

• Overview and history of the development of health insurance.
• Principles and conditions of insurance, and the health insurance law.
• Insurance classifications and types.

Module 2: Providers, Systems, and Policy Types

• Providers of medical services and healthcare systems.
• Types of health insurance policies and continuous/permanent coverage.
• The personal accident policy — definition, importance, and its relationship with medical accidents.

Module 3: Designing and Structuring Insurance Programs

• Designing health insurance programs and setting deductibles and co-payments.
• Methods for managing and planning insurance contracts.
• Health insurance correspondence, issuances, and claims.

Module 4: Costs, Claims, and Financial Management

• Managing medical expenses, premiums, and financing.
• Self-funded health insurance funds and claims calculation methods.
• How to calculate health insurance premiums and the key factors influencing the insurer's decision.

Module 5: Compliance, Fraud, and Real-World Application

• Understanding the relationship between insurance companies and insured persons.
• Recent amendments to insurance contracts.
• Identifying insurance fraud and how to detect it, with applied case examples.