Uncovering and Investigating Personal Lines Fraud

Overview

Fraudulent claims are a significant challenge within the insurance industry. Personal Lines insurance professionals (including insurance producers, underwriters, claims adjusters, and more) must be equipped with the knowledge and skill to identify, investigate, and mitigate personal lines fraud across various product lines. This course provides learners with information critical to identifying red flags of fraud, applying investigative techniques, effectively collaborating with all parties involved in investigating and handling fraud, and understanding fair claims handling practices. 

Find this course for your license


License or Certification 

 

Regulator 

 

Type 

 


Learning Objectives

  • Identify common types of fraud in Personal Lines and explain the impact on the insurance industry and consumers.
  • Differentiate between legitimate claims, opportunistic fraud, and organized fraud.
  • Recognize behavioral, circumstantial, and documentary red flags that may indicate fraudulent activity.
  • Describe investigative methods used to assess possible fraudulent activity.
  • Understand how to utilize SIUs, law enforcement, and legal counsel or action when fraud is suspected.
  • Implement ethical decision-making and effective communication when handling potential fraudulent activity while supporting fair claims handling.


Designed For:

Claims adjusters and other claims professionals with 3-5 years of
experience.




Course Information

Adding additional credit may change exam requirements.