NATIONAL INSURANCE ACADEMY
P687 – PROGRAMME ON
INSURANCE FRAUD DETECTION AND PREVENTION (LIFE)
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.
To learn about Insurance Fraud scenario in our country
To learn about IRDAI regulations and corporate guidelines for Fraud
To learn about Fraud detection and prevention tools
Educating participants about the potential areas of frauds
Introduction to cybercrime and cyber laws
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
Principles of Insurance & analysis of Claims Processing Procedure
& Insurance Fraud
Role of internal audit & inspection in detecting and preventing
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 an Claim Investigating Officer
(Claims), Manager (O.S.), Manager (CRM), Manager (F&A) & Manager (P&IR) to be
nominated by the respective Zonal HRDs
Members of ZTCs and MDC to be nominated by respective ZO HRD and CO HRD
Duration- 3 days