Overview
Insurance fraud remains one of the most significant challenges facing the insurance industry worldwide. Fraudulent activities increase claims costs, undermine insurer profitability, affect customer premiums, and place additional pressure on claims operations. As a result, claims professionals play a critical role in identifying, investigating, preventing, and responding to potential fraudulent activities while maintaining fairness, professionalism, and good-faith claims handling practices.
This programme provides a practical introduction to the relationship between claims management, ethics, professionalism, and insurance fraud prevention. Participants will explore the goals of the claims function, the importance of ethical and professional conduct, the challenges faced by claims representatives, common fraud motives and indicators, and the measures used by insurers and industry stakeholders to combat insurance fraud.
Learning Outcomes
On successful completion of this programme, you will be able to:
- Explain the primary goals of the claims function and their contribution to customer service and insurer profitability;
- Describe the importance of ethics, professionalism, and good-faith claims handling in claims management;
- Recognise ethical and professional concerns that may arise during the claims handling process;
- Explain the impact of insurance fraud on insurers, policyholders, and the insurance industry;
- Identify common motives, indicators, and types of insurance fraud encountered during claims handling;
- Describe the role of claims professionals in detecting, investigating, and preventing fraudulent claims; and
- Explain the anti-fraud initiatives undertaken by insurers, governments, and industry organisations to combat insurance fraud.
Course Outline
Price: US$125
Course Features
- Modules 9
- Duration 3 Weeks
- Content Type Text & media
- Assessment Yes
- Pass Percentage 70%
- Certificate Yes
