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 the insurance the ability to protect their organization from internal fraudulent activity such as Agent/Broker fee 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, viatical and senior settlement fraud.
This course uses a mixture of presentations, discussions, case studies, videos, role-plays and interactive exercises to transform participants’ knowledge into hands-on practice.
By the end of the course, participants will be able to:
- Define the role of ethics in financial fraud prevention
- Distinguish the nature and types of 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
This course is designed for all levels of auditors, investigators and prosecutors working in the finance fraud arena. Any professional looking to expand their knowledge of fraud detection and prevention would also benefit from this course.
- Preventing financial fraud
- Detecting fraud
- Implementing anti-fraud measures
- Investigating fraud
Governance and ethics in business
- Defining ethics
- Ethics in the workplace
- Conflicts of interest
- 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 mindset
- 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
Creating Environment for Dealing with Fraud
- Fraud related challenges and danger.
- Emotional responses to fraud.
- Establishing fraud policy and response.
- Auditor’s fraud responsibility
- Why people commit fraud.
- Types and categories of fraudster.
Fraud Detection & Computerized Environment
- How fraud surfaces.
- Five-step approach to fraud detection
- Fighting fraud right form staff recruitment stage.
- Fraud symptoms and “red flags”
- The responsibility of top management and human resource/ personnel department.
- Why auditors do not detect fraud.
- The responsibility and role of the internal security department.
- The fraud implications of technology
- Computer crime examples
- How to use computer audit retrieval for detection
- Principles of criminal investigation
- Collecting and systemizing of evidence
- Forming statements
- Interviewing and interrogation
- Polygraph and statement analysis
- Criminology/legal issue
- Investigative techniques