Insurance Fraud Prevention, Detection & Investigation.

Discover the Latest Fraud Detection Strategies an Technologies

Date: 24-27 March 2020
Venue: HB Connect Conference Center
Location: Sandton Johannesburg South Africa

Next Workshop
19-22 May 2020 Kampala Uganda
28-31 July 2020 Port Louis - Mauritius


Register Now! Limited Seats Available!

R 16,999.00 Per Delegates


The insurance industry is modernizing fast in numerous ways. The technology breakthrough during the last years and has brought an increase in the insurance frauds field. Thus, as a consequence, this outcome is changing the landscape in the sector. In this new fraud environment, effective fraud prevention has become even more important and vital for maintaining profitability and customer loyalty.

A modern, fraud combat squad presents the critical factor which will give the competitive advantage to the modern insurer to tackle fraud, increase profitability, beat competition and expand to new business challenges based on a better, robust and low risk customer base

 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 and senior settlement fraud. Latest Fraud Detection Strategies and Technologies will also be discussed.

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:

  • Explore how the fraud perpetrator’s use of the covenant of good faith and fair dealing to defeat insurer’s claim of attempted insurance fraud.
  • Recognize the elements insurance fraud and the proof needed to assert fraud as a defence.
  • Identify what investigation will be performed to stop fraud.
  • Explore how the statutory requirement to thoroughly investigate potential fraud makes successful fraud difficult.
  • 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
  • Evaluate and challenge management’s fraud risks
  • Think like a fraudster – The only way to spot frauds
  • Apply successful techniques to help prevent fraud
  • Promote an effective fraud-prevention process
  • Adopt data mining as a fraud prevention and detection tool
  • Apply an effective fraud investigation process
  • Apply audit skills to fraud investigation
  • Spot when someone is not telling you the truth
  • Monitor the legal compliance with anti-fraud legislation

Targeted Audience

  • Auditing
  • Preventing insurance fraud
  • Detecting insurance fraud
  • Implementing anti-fraud measures
  • Investigating fraud
  • Internal auditors in organisations without a dedicated fraud team
  • Auditors who need to learn about the most modern approaches to fraud prevention and investigation
  • Newly appointed fraud specialists
  • Members of fraud teams who need to learn more about targeting internal fraud
  • Managers needing a broader understanding of how to prevent and detect 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
  • Discover the Latest Fraud Detection Strategies and Technologies
    • Hear about new industry trends and practical fraud-fighting improvements. This session is your best opportunity of the year to uncover what’s working in fraud management—and what to watch out for as fraudsters use new technologies to their advantage.

Whilst BMK Training has core courses which we offer on an international basis to both companies and individuals, we also recognise that from time to time, your company may have specific training requirements that cannot be satisfied in a public training environment.

We can bring our Training/workshops directly to your workplace or we will customize training to meet your specific needs ensuring effectiveness in achieving real performance improvement.
If you have 8 or more delegates then, in house training can be of a greater advantage for your organization.

Advantages of in-house training include:

  • Cost savings up to 50% of the training expenses with more effective group training.
  • Training is confidential, allowing teams to discuss and work on real issues as trainers will usually sign confidentiality agreements.
  • In-house training encourages team building and better understanding of one another
  • Training is fully-customized for any team, department, or organization

For Registration and other Training arrangements
contact us on the detail below
SA Tel: +27 11 057 6001    /   TZ Cell: +255 688 032 910
WhatsApp +27 79 574 0389 /  Fax: +27 862 637 253