NATIONAL
INSURANCE ACADEMY
PUNE
P687
– PROGRAMME ON INSURANCE FRAUD DETECTION AND PREVENTION (LIFE)
(2024 -
25)
Background:
The financial sector has been
witnessing increasing number of frauds leading to losses to companies to the
tune of thousands of crores. The
nature of frauds has also undergone changes in tune with changes in the
composition of the society, attitude of the people, improved technology etc.
Cyber Crime has gained much ascendance in the last few years.
The insurance sector is no exemption to the frauds that are taking place
in the financial sector.
The frauds that have been
perpetrated have raised doubts on Corporate Governance, Business Ethics,
Auditor’s role, Regulator’s role etc. Hence
every stakeholder needs to be alert and play his/her role effectively and help
companies to detect such frauds.
IRDAI regulations and
organisational guidelines on detecting and preventing Insurance frauds need to
percolate to bottom of the pyramid so that there is an organisational fight
against this organised crime.
Objectives:
§
To learn about Insurance Fraud scenario in our
country
§
To learn about IRDAI regulations and corporate
guidelines for Fraud mitigation
§
To learn about Fraud detection and prevention
tools
§
Educating participants about the potential
areas of frauds
§
Introduction to cybercrime and cyber laws
Contents:
§
Fraud Scenario in Insurance sector (worldwide)
§
IRDAI Corporate Governance
Guidelines
§
Regulatory Framework for prevention of
Insurance frauds
§
Risk Management Systems and processes
§
Role of internal operating procedures in
preventing frauds.
§
Cyber frauds threats (Role of technology and
social media)
§
Money Laundering in Insurance including
AML/CFT/FATKA,
§
Intelligence and Investigating tools &
techniques in insurance Frauds.
§
Principles of Insurance & analysis of
Claims Processing Procedure & Insurance Fraud
§
Role of internal audit, inspection & vigilance in detecting and
preventing frauds.
§
Forensic Audit
§
Data Mining & Analytics in Fraud Mitigation
§
IT Act 2000/2008
§
Information Security (Policies &
Safeguards)
§
Anti-Fraud Policy of LIC
§
Whistle blower policy & Integrity Pact
§
Case studies and group discussion
§
Role of a Claim Investigating Officer
Participants
Profile:
§
Manager (Claims), Manager (O.S.), Manager (CRM), Manager (F&A) & Manager (P&IR)
to be nominated by the respective Zonal HRDs
§
Faculty Members of ZTCs and MDC to be nominated by respective ZO HRD and
CO HRD
Duration:
3 days
Dates:
I.
29.04.2024 - 01.05.2024
II.
23.09.2024 - 25.09.2024
III.
28.10.2024 - 30.10.2024
IV.
27.01.2025 - 29.01.2025