CII CPD accreditation Diploma
Medical Insurance Diploma
دبلومة التأمين الطبي
A specialist professional diploma within the two programmes holding CII CPD Accreditation at the Insurance Institute of Egypt.
CII CPD AccreditedDELEGATE GUIDE
Joining & Study Instructions
Medical Insurance Diploma · 2026 cohort
These instructions are the general approved guide for joining and studying and apply to all cohorts unless formally updated by the Insurance Institute of Egypt. The start date and timetable below are specific to the 2026 cohort.
80%Minimum attendance
70%Overall pass mark
1Examination resit
01
Joining and timetable
Delivery Mode and Session Access
The diploma is delivered in hybrid mode. Delegates may attend in person or online in accordance with the arrangements announced by IIE.
A dedicated WhatsApp group is created for the diploma and includes the Diploma Manager, all instructors, delegates, and an IIE administration representative.
The group is used to circulate access links, announcements, lecture recordings, academic and administrative instructions, and to resolve matters related to the diploma.
The venue and online access details will be communicated through IIE official channels and the dedicated diploma WhatsApp group.
02
Attendance and Punctuality
The minimum required attendance is 80% of the scheduled sessions.
Delegates should arrive at the training venue or log in to the online session at least 15 minutes before the scheduled start time.
Any late arrival exceeding 15 minutes is recorded as lateness. Every three such late arrivals are counted as one day of absence.
For online attendance, delegates must use the access link issued by IIE and display their full registered name. Access details must not be shared with any unregistered person.
Attendance and active participation form part of the final assessment in accordance with the weighting shown in these instructions.
Three arrivals more than 15 minutes late count as one day of absence.
03
Pre-work, Learning Materials and Recordings
The complete learning materials are provided to the delegate upon joining/attendance. Materials are for delegates’ learning use and must not be redistributed without permission.
Lecture recordings remain available throughout the diploma period, and the recording of each lecture is sent to delegates after the session.
A recording after every lecture, available throughout the diploma.
Preparation and assignments
No pre-work is required before the diploma starts unless delegates are specifically notified of a requirement for a particular session or assignment.
Delegates are expected to review the materials provided and complete periodic assessments, research, and any assignments required under the approved diploma plan.
04
Assessment and certificate
The learning objectives are introduced at the start of the learning activity and revisited at the end, in line with the objectives published in the diploma brochure and official programme page.
Learning objectives and diploma details| Assessment component | Weighting |
|---|---|
| Final examination | 60% |
| Periodic assessments | 20% |
| Research | 10% |
| Attendance and discussion | 10% |
70%
The required overall pass mark for the completion certificate is 70%, subject to meeting the approved attendance, completion, and assessment requirements.
In the event of failure or absence from the examination, one re-examination is permitted only once, subject to a fee of EGP 1,000.
Up to 144 CPD hours — within the approved scope, excluding breaks where applicable.
Completion certificate and CPD hours
The completion certificate is issued subject to the diploma’s attendance, completion, and assessment requirements.
Learning objectives and feedback
Delegates will be asked to complete the programme feedback form, including evaluation of content, instructors, materials, and whether the learning objectives have been met. Results are used for quality monitoring and continuous improvement.
05
Cancellation, Withdrawal, Substitution and Deferral
All cancellation charges are calculated on the total diploma fee and are borne by the delegate or the nominating/sponsoring entity, depending on who is responsible for payment.
50%
Cancellation before the diploma starts
If cancellation is requested before the diploma starts, the paying party is responsible for 50% of the total diploma fee.
100%
Cancellation after three lectures without notice of absence
After the diploma has started and three lectures have passed without written notice or supporting information regarding absence, cancellation or withdrawal results in the paying party being responsible for 100% of the total diploma fee.
Requests and refund timing
A cancellation request from the delegate or nominating entity must be sent to: education@iiegypt.com.
Where a refund is due, the refundable amount will be processed within one month from the cancellation date.
Replacement delegates or deferred registration
The nominating entity may substitute the nominated delegate or defer the registration to a later cohort, provided the request is submitted at least 15 days before the diploma start date.
06
Contact and acknowledgement
Support and Communication
The dedicated diploma WhatsApp group is the primary day-to-day communication channel connecting delegates, the Diploma Manager, instructors, and the IIE administration representative.
Academic and administrative enquiries, session-access issues, instructions, and diploma-related updates are handled through the group and IIE official communications.
IIE can also be contacted by telephone: +202 333 51 413 · +202 333 51 417 · +202 333 51 424.
Email: education@iiegypt.com - customer.serv@iiegypt.com.
Formal cancellation requests must be sent to: education@iiegypt.com.
education@iiegypt.comDelegate Acknowledgement
Participation in the diploma, use of the issued access details, and completion of registration constitute the delegate’s acknowledgement that these study, attendance, assessment, and cancellation instructions have been read, accepted, and will be followed.
Keep your study guideMedical Insurance Diploma · English edition
Download PDFProgramme information
Everything you need to know
An integrated professional programme connecting the technical foundations of medical insurance with modern operational and management practice, from product design and pricing through underwriting, claims, cost control and service quality.
Who should attend?
- Insurance, reinsurance and brokerage professionals
- HR and employee-benefits specialists
- Healthcare management and provider staff
- Graduates seeking a career in medical insurance
Learning objectives
- Explain medical-insurance principles and insurable risks; distinguish individual and group cover.
- Interpret policy benefits, coverage limits, cost-sharing provisions and exclusions.
- Describe product design, marketing, underwriting, pricing and the role of reinsurance in a medical portfolio.
- Analyse operating costs, claims and loss ratios; identify fraud and misuse controls.
Scientific content
- Medical insurance and healthcare-system foundations
- Product development, marketing and distribution
- Underwriting, pricing and experience analysis
- Policy administration and claims management
- Provider networks and cost containment
- Reinsurance for medical portfolios
- Fraud control, service quality and data protection
Study and assessment
- Applied lectures, case studies and practical exercises
- Continuous assessment, participation and an applied assignment
- Final assessment in accordance with programme rules
Certificate and accreditation
This diploma is one of the two programmes holding CII CPD Accreditation. Learners meeting attendance and assessment requirements receive an Insurance Institute of Egypt completion certificate.
Approved learning framework
Scientific Content and Detailed Learning Objectives
The following sections present the curriculum structure, detailed learning objectives and intended outcomes for each part of the diploma. The complete original remains available in the brochure below.
Programme 01
Health Insurance Fundamentals and Coverages
Learning objectives
- Explain the technical and legal principles of insurance, how insurance systems operate, and how risk is distributed.
- Identify insurable risks and the conditions for accepting them, and explain the concept of medical insurance and its key terminology.
- Distinguish between individual and group health insurance and between the types of insurance entities and their market roles.
- Analyse medical-expense coverages, including basic, comprehensive and supplementary cover, and different indemnity plans.
- Interpret medical-insurance policy provisions, including benefits, deductibles, coinsurance, maximum limits, exclusions and the legal rules governing the policy.
After completing this programme, the learner will be able to:
- Analyse a risk scenario, determine whether it is insurable, and justify the decision using technical and legal principles.
- Identify the parties to an insurance relationship and use key terminology correctly when analysing a medical-insurance case.
- Classify cover as individual or group, and identify the type and role of the insurance entity and the extent of risk it assumes.
- Select medical cover appropriate to a client's needs and distinguish between basic, comprehensive and supplementary coverages.
- Read a medical-insurance policy and interpret its benefits, limits, exclusions and the obligations of its parties.
Programme 02
Marketing, Pricing and Management of Health Insurance Operations
Learning objectives
- Explain the foundations of marketing, selling and pricing individual and group health-insurance products.
- Identify the stages of product development and insurance-proposal design, distribution channels, and the roles of agents, brokers, consultants and group-insurance representatives.
- Explain health-insurance underwriting principles and the factors affecting risk assessment, pricing and profitability.
- Explain how reinsurance supports a health-insurance portfolio and reduces volatility in losses.
- Explain the health-insurance operating cycle from policy issue and renewal through claims management, including ways to improve cost-effectiveness and control operating expenses.
After completing this programme, the learner will be able to:
- Segment the health-insurance market and identify the target customer, their needs, and the appropriate distribution channel for an individual or group product.
- Prepare an initial product and insurance proposal covering benefits, terms, premiums, the sales plan, enrolment procedures and activation.
- Analyse individual or group data and identify the risk factors affecting underwriting and pricing decisions.
- Explain when reinsurance is required and how it protects the portfolio and stabilises its results.
- Trace the policy and claims cycle, identify points of cost escalation, and propose measures to improve efficiency and control operating expenses.
Programme 03
Medical Insurance Costs, Operations Management, and Fraud Prevention
Learning objectives
- Understand the components of medical-insurance cost and the factors affecting pricing, profitability and loss ratios, while distinguishing individual from group insurance costs.
- Understand the medical-insurance operating cycle, including the administration of policies, premiums, approvals and claims, and the monitoring of service providers.
- Understand how marketing and sales costs, underwriting principles and portfolio management affect the balance between growth and profitability.
- Distinguish fraud, abuse and waste; recognise their main forms and warning indicators; and understand prevention and detection methods.
- Understand the laws and regulations governing medical-insurance operations, fraud prevention and the related obligations.
After completing this programme, the learner will be able to:
- Analyse the cost components of a medical-insurance portfolio, explain their effect on pricing, profitability and the loss ratio, and compare individual with group insurance.
- Apply the operating cycle and policy administration process from issue and premium collection through approvals, claims review and settlement, and provider monitoring, while identifying control failures and points of cost escalation.
- Assess the effect of marketing and sales costs on the final price and make an underwriting decision that appropriately balances risk acceptance, growth and profitability.
- Detect harmful practices and classify them as fraud, abuse or waste, identifying the warning indicators and appropriate response for each case.
- Design a simplified fraud-prevention and detection framework covering control, reporting, review and documentation, while applying the governing laws and controls.
Programme 04
Healthcare Management
Learning objectives
- Identify the types of integrated healthcare-management organisations and models and their different market roles.
- Understand provider-network management, contracting, reimbursement and payment systems, and the allocation of risk among the parties.
- Understand healthcare-quality standards and approaches to utilisation management.
- Understand the organisational structure, internal operations, information systems and governance of healthcare-management organisations.
- Understand the laws and regulations governing healthcare-programme management companies and their obligations to insurers, customers and service providers.
After completing this programme, the learner will be able to:
- Compare healthcare-management models, including indemnity plans, PPOs, EPOs, POS plans, HMOs and self-funding, and select the model appropriate to a given case.
- Prepare a medical-network management plan covering provider selection and contracting, the payment method, and the monitoring of cost, performance and quality.
- Apply utilisation and quality-management tools, including demand management, referral, prior authorisation, concurrent review, case management and retrospective review.
- Analyse the organisational structure and operational workflow of a healthcare-management organisation, identifying departmental responsibilities, control points and required reports.
- Assess a healthcare-programme management company's compliance with laws and regulations, identifying permitted and prohibited activities and its operational and contractual obligations.
CII-approved document
Full official diploma brochure
The complete approved programme document is displayed below and can also be opened or downloaded.
Programme forms
Admission and compliance form
IIE learner admission details, declarations and compliance policies.
Programme forms
Delegate feedback form
The end-of-programme form for evaluating the programme, trainer, content and services.
Registration enquiry
Contact IIE to register
Contact the Institute for current registration information and assistance with the application process.