European Institute of Management and Finance | Insurance and Health Care Fraud
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Insurance and Health Care Fraud

Insurance and Health Care Fraud


Insurance fraud is one of the most serious problems threatening the viability of insurance companies. Insurance frauds are driving up the overall costs of insurers and premiums for policyholders. It encompasses a wide range of illicit practices and illegal acts. Over the last couple of years Insurance companies have witnessed an increase in the number of fraud cases.


The programme will introduce participants to Insurance and Health Fraud, which are interrelated, will cover reasons behind fraudulent acts, the most important types of Insurance and Health Fraud as well as measures for prevention.



Training Objectives


The training will focus on providing participants with a basic understanding of Insurance Fraud and awareness of the most significant types of Insurance and Health Care Fraud. By the end of the programme, participants will be able to:


  • Understand what Insurance Fraud is
  • Identify the reasons behind fraudulent acts
  • Learn the main types of Insurance Fraud Schemes
  • Learn how to identify cases of Insurance Fraud
  • Understand what Health Fraud is
  • Learn the various Health Care systems
  • Understand the main Health Care Fraud Schemes
  • Learn how to identify cases of Health Care Fraud
  • Apply basic prevention measures



Training Outline


  • Introduction to Insurance and Health Care Fraud
  • Fraud Triangle
  • Basic Insurance Fraud Schemes
  • Red flags
  • Main Health Care systems
  • Basic Health Care Fraud Schemes
  • Basic prevention measures
  • Case studies



Training Style


This programme is designed to deliver knowledge and enhance participants’ skills via brief lectures, practical examples and case studies. Significant amount of time will be invested in analysing real-life case studies which will assist participants to develop necessary skills so as to handle a potential case.



CPD Recognition


This programme may be approved for up to 5 CPD units in Insurance Services. Eligibility criteria and CPD Units are verified directly by your association, regulator or other bodies which you hold membership.


Professionals requiring CPD units to meet the education requirements for an occupational licence renewal, and/or for maintaining other professional memberships/certifications which accept CPD in Insurance Services, are advised to consider training subjects in categories that indicate CPD training in Insurance Services.



Who Should Attend


The programme is ideal for:


  • Insurance Professionals and Executives in Insurance Firms
  • Internal Auditors of both public and private sectors
  • External Auditors
  • Accountants
  • Lawyers
  • Risk Management professionals
  • Compliance Officers
  • Financial Controllers & Directors
  • Underwriters