Insurance Fraud is estimated to take between $80 and $300 billion a year from the property and casualty insurance industry, raising the prices each person pays for insurance by more than $300 a year.

This course explains what insurance fraud is and discusses various methods by which insurance fraud is perpetrated. It also covers the various weapons provided by statutory law, legal precedent and professional claims handling that enable companies to reduce the amount stolen by fraud perpetrators. Furthermore, it explains the use of red flags or indicators of insurance fraud and the use of an insurance company Special Investigation Unit (SIU) to gather the evidence necessary to assist in the defeat of insurance fraud.

Learning Objectives
  • Recognize what insurance fraud is
  • Explore the methods needed to investigate and defeat insurance fraud attempts.
  • Identify legal bases available to defeat insurance fraud.
  • Explore the reason why it is in the best interest of insurance companies to actively work to defeat attempts at insurance fraud.
Last updated/reviewed: August 7, 2023
14 Reviews (54 ratings)

Reviews

5
Member's Profile
Very informative. I learnt a lot and my knowledge is widened. Thanks a bunch
3
Member's Profile
Barry needs more energy. What he says is really interesting. But his monotone presentation even had him yawning (I actually heard him yawn twice). The exam (CPE for me) was unpleasant as well. Maybe that was the intent.
3
Member's Profile
A good survey, if a bit dry. The medical fraud is most useful to me in looking at our owner-controlled insurance program, which covers Workers' Comp and General Liability for our contractors and subs.
5
Member's Profile
Barry Zaman is a rock star and an American Treasure. I just loved this course. I learned so much about the types of medical fraud that I just never knew existed. My eyes have been opened.
3
Member's Profile
The course material was great. The instructor seemed to have low energy and I think he yawned a couple times during the presentation.
4
Anonymous Author
I liked that I learned how many different ways of Insurance Fraud are done. The examples were very informative.
4
Anonymous Author
Good overview of insurance fraud, the types of fraud, relationship between the insurer and the insured.
5
Member's Profile
The Insurance Fraud course was beneficial, because of how important fraud is in our everyday life.
4
Member's Profile
Good discussion of types of insurance frauds. Slow, but good.
5
Anonymous Author
Good content and very relevant to me for my line of work.
5
Member's Profile
Like a Law and Order episode with CPE credits.
1
Anonymous Author
Painfully slow paced.
5
Member's Profile
Interesting topic.
4
Anonymous Author
Good course.
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Prerequisites
Course Complexity: Intermediate

Prerequisite: Exposure to insurance policies

 

Advanced Preparation: None

 

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 or send an e-mail to .
Instructor for this course
  Course Overview CPE
Course Syllabus
INTRODUCTION AND OVERVIEW
  5:58PREVIEW: Introduction to Insurance Fraud
Types of Insurance Fraud
  Types of Insurance Fraud 11:43
  Types of Insurance Fraud Cont.14:30
Liability Claims
  Liability Insurance Claims Handling 7:39
  Good Faith and Fair Dealings11:43
  Suspected Fraud in a 3rd Party Liability Claim11:15
First Party Property Claim
  The First Party Property Claim13:35
  The First Party Property Claim Cont.9:54
CONCLUSION
  Philosophy of Denial of a Fraudulent Claim6:02
Continuous Play
  Insurance Fraud: An Overview1:32:23
SUPPORTING MATERIALS
  Slides: Insurance FraudPDF
REVIEW & TEST
  REVIEW QUESTIONSquiz
 FINAL EXAMexam