Insurance Fraud

Overview

Insurance fraud is any deliberate act of deceit, falsehood, or other dishonest undertaking perpetrated against or by an insurance company or its agents for the purpose of unwarranted financial gain. Fraud can occur at any time during the process of buying or selling insurance, during the term of the policy, during the underwriting process, or with the filing of claims. Types of insurance fraud are varied and occur in virtually all lines of coverage. It is important to know how insurance fraud is committed and how it affects those involved. 

This course provides an in-depth look at insurance fraud. Appropriate for both life/health and property/casualty producers, it explains the nature of insurance fraud, when and how it is committed, and the parties typically involved. The course explores the most common types of property, casualty, life, and health insurance fraud and the various technologies, both high tech and low tech, that are used to combat insurance fraud. The course concludes with a chapter on how to fight insurance fraud and presents numerous red flags that are common fraud indicators. 

Learning Objectives

Upon conclusion of this course, students should be able to:

  • understand the effects and implications of insurance fraud
  • distinguish between hard and soft insurance fraud
  • compare internal fraud and external fraud and cite examples of both
  • describe the many types of property and casualty fraud
  • understand the scope of life insurance fraud and the schemes used to carry it out
  • identify health insurance fraud and recognize its participants
  • understand how insurance fraud is detected by both sophisticated and low-tech methods
  • cite the red flags that suggest insurance fraud in various types of coverage

Designed For

Insurance agents and producers
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