This course will cover the issues associated with insurance fraud. Examples of various types of insurance fraud, including application frauds and claims frauds will be presented. We will also discuss frauds committed by insurance agents and companies. Participants will have the opportunity to review the red flags that could be an indicator of insurance fraud. The procedures for conducting an insurance fraud investigation will be discussed and the legal issues will be examined. We will discuss strategies for preparing both civil and criminal insurance fraud cases. We will also discuss internal controls and procedures that could help to prevent or detect insurance fraud. We will review federal and state insurance fraud laws. Case studies will be presented to allow the participants to practice the skills learned in this course.
Upon successful completion of the course, the student will be able to do the following:
- Understand the basics of insurance fraud
- Understand subrogation
- Have a basic understanding of worker’s compensation, disability, property insurance and fire/arson cases
- Identifying red flags that could indicate insurance fraud
- Conduct Fraud Investigations
- Preparing for a civil case
- Prepare for a criminal case
- Prepare for courtroom testimony in insurance fraud cases
- Prepare reports for insurance fraud cases
- Identify controls to prevent and detect insurance fraud
An exam will be administered upon the conclusion of the program. If the candidate passes with a score of 70 percent or better a certificate of completion will be issued in accordance with acceptable standards.