Diploma In Insurance Fraud Investigation

The Professional Diploma in Insurance Fraud Investigation by SIFS India is a specialized course that focuses on investigating fraudulent insurance claims.

The course content is designed meticulously to equip students with expertise to protect the integrity of the insurance industry. The course is designed to equip you with the knowledge and skills necessary to investigate insurance fraud cases, conduct interviews, and gather evidence to present in court.

The course curriculum covers a vast range of topics to successfully conduct in-depth investigations, like overview and purpose of insurance fraud investigation, insurance fraud prevention model act, types of insurance claims, procedure to file claims, red flags of insurance fraud, first-and-third-party policy, use of technology in insurance fraud investigation, interview techniques and interrogation skills, documentation requirements, surveillance methods and preparation techniques, types of surveillance, legal principles governing insurance fraud investigation, and case-specific fraud investigations like suicide, accident, fire, and explosion.

Upon successful completion of this professional course, you will have the opportunity to work for law enforcement and government agencies, financial institutions, legal firms, risk management firms, insurance companies, the healthcare sector, education and training institutions, and consulting firms.

With the rise in population and excessive use of technology, the insurance industry too is facing an increase in fraud cases. The demand for skilled professionals is not going to go down in the coming years. Become a trusted insurance fraud investigator, uncover deception, and safeguard the financial stability of the insurance industry.

Curriculum:

• Module 1 – Introduction To Insurance Fraud Investigation
• This module covers insurance fraud-related topics like purpose, various types of insurance fraud, and the role of insurance fraud investigators. You will also learn about the significance of an insurance fraud investigation to fight fraudulent activities, ensure the smooth functioning of the insurance industry, and protect consumer interests. The module also highlights ethical considerations to follow while carrying out insurance fraud investigations.
• Module 2 – Insurance Claims Process
• In this module, you will learn about insurance claims, types of claims, the crucial role insurance fraud investigators play, and procedures to file insurance claims with accuracy. This module also covers common causes of fraudulent claims and equips you with knowledge to identify red flags and effectively investigate and prevent insurance fraud.
• Module 3 – Policy: The Contract
• This module covers basic concepts about insurance policies, such as legally binding contracts, the language and structure of policies, and the difference between first- and third-party policies. You will also gain insights about the concept of innocent co-insured parties and will be able to explain their rights within the insurance contract framework, along with knowledge of the legal angle of insurance policies.
• Module 4 – Investigative Techniques And Tools
• In this module, you will learn the tools needed for insurance fraud investigations, specific investigative techniques, technology usage like data analytics and predictive modeling to identify fraudulent patterns, and interview and interrogation skills to extract crucial information as evidence during an investigation. These skills will help you understand investigative methodologies precisely.
• Module 5 – Documentation And Reporting
• This module covers features of insurance fraud investigation documentation and reporting, techniques to gather information within a legal framework, documentation requirements specific to insurance fraud investigations, and skills for writing detailed investigation reports. You will also gain proficiency in effectively presenting your findings to stakeholders, along with ethical considerations to maintain truthfulness in your work.
• Module 6 – Conducting Surveillance
• This module explores surveillance techniques (foot surveillance, vehicle surveillance, fixed surveillance, and even satellite and night surveillance), surveillance methods, and surveillance preparation. You will also learn about the importance of vendor management in equipping you with the skills and knowledge to efficiently coordinate and use external resources when conducting surveillance operations.
• Module 7 – Legal Aspects Of Insurance Fraud Investigation
• In this module, you will gain an understanding of legal principles, laws in context to insurance fraud investigations (statutes and regulations), and how case law and judicial precedents help shape the legal framework for investigations. The module also outlines evidence collection and preservation procedures so that you, as an investigator, stick to legal standards throughout your work.
• Module 8 – Case-oriented Insurance Investigation
• This module explores specialized areas of insurance fraud investigation, like fraudulent disability investigations, motor vehicle accident investigations, premise accident investigations, railroad crossing investigations, suicide investigations, accident reconstruction fundamentals, fire and explosion investigation techniques, the need for photographing while documenting evidence, and different scenarios you may encounter.