Fraud Detection and Prevention for the Insurance Industry

Program description & objectives

Program description & objectives Insurance fraud is a hydra-headed problem that has been growing in leaps and bound over many decades. The frightening revelation, however, is that most developing economies and the responsible regulatory agencies/parastatals are not yet focused on the immense level of fraud and rot in this area. This course, therefore, covers how to prevent fraud, how to detect fraud, the tools to investigate fraud, and how to gather information, and how to prepare a case for prosecution as it relates to the insurance industry. This course gives fraud professionals the necessary tools required to monitor and clean the rot that pervades the insurance industry. Regulatory practitioners would have the ability to protect the economy from internal fraudulent activity such as Agent/Broker premium diversion, re-insurance fraud, and rented asset schemes. The program also covers external fraud activities such as fake insurance companies, offshore/unlicensed internet companies, staged auto accidents, viatical and senior settlement fraud. This course utilizes a mixture of presentations, discussions, case studies, videos, role-plays and interactive exercises to transform participants’ knowledge into hands-on practice. It is expected that, by the end of the course, delegates 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