Fraud Detection and Prevention for the Insurance Industry Training Courses -

Fraud Detection and Prevention for the Insurance Industry

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Why Attend

This course covers how to prevent fraud from happening, how to detect fraud, the tools to investigate fraud, and how to gather a case for prosecution. This course gives professionals working in the insurance industry the ability to protect their organization from internal fraudulent activity such as Agent/Broker premium diversion, re-insurance fraud and rented asset schemes. It also covers external fraud activities such as fake insurance companies, offshore/unlicensed internet companies, staged auto accidents, viatical and senior settlement fraud.

Course Methodology

This course uses a mixture of presentations, discussions, case studies, videos, role-plays and interactive exercises to transform participants’ knowledge into hands-on practice.

Course Objectives

By the end of the course, participants will be able to:

Define the role of ethics in insurance fraud prevention
Distinguish the nature and types of insurance fraud
Set up fraud prevention methods for the organization
Identify and implement anti-fraud measures and manage fraud risks
Investigate and form a legal case to prosecute suspected fraudsters

Target Audience

This course is designed for all levels of auditors, investigators and prosecutors working in the insurance fraud arena. Any professional looking to expand their knowledge of insurance fraud detection and prevention would also benefit from this course.

Target Competencies

Auditing
Preventing insurance fraud
Detecting insurance fraud
Implementing anti-fraud measures
Investigating fraud

2019 - Location & Date

4 Days Course

No Schedules!
Please Contact Us if you have any queries..

Schedule for Me

2020 - Location & Date

4 Days Course

No Schedules!
Please Contact Us if you have any queries..

Schedule for Me

Fees

Per participant - 2020

USD 4,800

Fees + VAT as applicable

Tax Registration Number : 100239834300003

(including coffee breaks and a buffet lunch daily)

Discount Plans & Cancellations Policy

Attending this course will grant participants 30 CPE credits from the following associations: The Institute of Internal Auditors (The IIA), Information Systems Audit and Control Associations (ISACA) and the Association of Certified Fraud Examiners (ACFE).

Course Outline

Governance and ethics in insurance
- Defining ethics
- Ethics in the workplace
  - Conflicts of interest
  - Fraud
  - Racism
  - Other misconduct
- Conducting ethics investigations
- Skills and approaches of the ethics investigator
- Moral hazard in insurance
- Adverse selection

Fighting fraud types
- Core foundation: basic concepts of fraud, anti-fraud mind set
- Life insurance fraud
- Health insurance fraud
- Auto insurance fraud
- Property insurance fraud
- Reporting insurance fraud
- The role of the fraud investigator
- Internal audit’s role in preventing fraud

The broker’s perspective
- Types of fraud
- The broker’s role
- Anti-fraud measures
  - In house anti-fraud units
  - Software alerts
  - Databases facilitating sharing of claims information (e.g., CUE, MIAFTR, MID, CIFAS)
  - Cognitive interviewing techniques
  - Lie detectors/voice stress analysis
  - Aerial photography and mapping
- Managing broker fraud risks
- Broker response to fraud

Fraud Investigations
- Tasks of the fraud investigator
- Setting the standards
- Reviewing controls
- Searching for corroborating evidence
- Spotting fraudulent claims
- Theoretical and legal issues pertaining to fraud investigations
- Multi-disciplinary approach to fraud investigations
- General legal issues

Criminal Investigations
- Principles of criminal investigation
- Collecting and systemizing of evidence
- Forming statements
- Interviewing and interrogation
- Polygraph and statement analysis
- Criminology/legal issues
- Investigative techniques

Banking, Insurance and Financial Services

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