Fraud Detection and Prevention for the Insurance Industry PLUS Specialty Training
Price: AED 15,425
  • Location: JLT - Dubai
  • Duration: 4 Days

    Course details

    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

    • 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

    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
    Updated on 16 November, 2017

    About PLUS Specialty Training

    As a division of Meirc, PLUS Specialty Training provides highly specialized, technical and industry-specific training courses using leading freelance subject matter experts, practitioners, and technical trainers.

    Training Courses
    In response to requests from Meirc’s and PLUS’ participants, PLUS offers training courses focused on specialized and industry-specific topics:
    • Public / open training courses are delivered in:
    • 3 or 5 days
    • English or Arabic
    • Dubai or Abu Dhabi
    • In-house / in-company courses are available in all topics, upon request
    Methodology
    • Training courses are facilitated by leading freelance subject matter experts
    • Due to the advanced nature of the topics delivered, trainers who are senior practitioners in their field are sourced, recruited, and contracted to share their relevant experience and expertise
    • PLUS ensures that all trainers, content, and facilitation meet Meirc’s high and reputable standards of quality, reliability, and integrity
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