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Duration: 2 Hours
Level: Intermediate
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Expert Certifications

This is a complete course of study providing education and training which allow the student to learn how to deal with the need to eliminate insurance fraud in the United States. You will review and understand the wording of the commercial general liability insurance policy.

This is the eleventh course in the series helps a representative of an insured become aware of what is required of an insured to assist an insurer in its investigation, defense and defeat of insurance fraud. It also allows the insurer to complete a thorough investigation of a liability claim made against the insured and to assist the insurer in its obligation to defend, indemnify and defeat an insurance fraud attempt.

This course covers the following:

  1. The definition of fraud and evidence needed to prove fraud.
  2. The definition of insurance fraud.
  3. How to recognize insurance fraud.
  4. The evidence needed to prove that insurance fraud was attempted.
  5. An example provided by California criminal insurance fraud statutes that allow arrest, trial and conviction of insurance fraud perpetrated.
  6. What an insurer must do when fraud is suspected.
  7. The red flags or indicators of insurance fraud.
  8. The Special Fraud Investigation Unit.
  9. Insurance fraud is a crime in most states.
  10. The example of how California statutes deal with insurance fraud.
  11. A description of various liability claims schemes.
  12. The authority for denial of a claim for fraud.
  13. How to deny a fraudulent insurance claim.
  14. The philosophy governing denial of a fraudulent claim.

 

Learning Objectives

  • Identofy what fraud is.
  • Identify what insurance fraud is and why the insured and insurer must work together to defeat insurance fraud.
  • Explore how liability insurers work to defeat attempted insurance fraud using a Special Fraud Investigation Unit and competent counsel.
  • Identify each of the elements of insurance fraud.
  • Discover that it is the duty of the insured to assist the insurer in its attempts to defeat insurance fraud.
  • Discover how to recognize insurance fraud by a thorough understanding of the red flags of fraud.

Prerequisites

No Advanced Preparation or Prerequisites are needed for this course. However, it is recommended to take the other courses in the series prior to completing this one.

Education Provider Information

Company:
Illumeo, Inc., 75 East Santa Clara St., Suite 1215, San Jose, CA 95113
Contact:
For more information regarding this course, including complaint and cancellation policies, please contact our offices at (408) 400- 3993 ext. 106, or send an e-mail to .
Course Syllabus
INTRODUCTION AND OVERVIEW
  6:30Introduction to Course 11: Insurance Fraud Prevention
  12:22What is Insurance Fraud?
  17:06What is Insurance Fraud? Cont'd
  12:55Insurance Fraud is a Crime
  8:28Insurance Fraud is a Crime Cont'd
  4:59Fraudulent Claim Schemes
  11:15Red Flags of Fraud
  15:56To Defeat Fraud the Claims Professional Must
  1:43Policy Wording That Assists in Insurance Fraud Prevention
CONTINUOUS PLAY
  1:31:13Course 11 - Insurance Fraud Prevention
SUPPORTING MATERIALS
  PDFSlides: Insurance Fraud Prevention
  PDFInsurance Fraud Prevention Glossary/Index
REVIEW AND TEST
  quizREVIEW QUESTIONS
 examFINAL EXAM