NATIONAL
INSURANCE ACADEMY
PUNE
P687
– PROGRAMME ON INSURANCE FRAUD DETECTION AND PREVENTION (LIFE)
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 organizational guidelines on detecting and preventing Insurance
frauds need to percolate to bottom of the pyramid so that there is an organizational
fight against this organized 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 in detecting and
preventing frauds.
§
Preventive Vigilance
§
Forensic Audit
§
Data Mining & Analytics in Fraud Mitigation
§
IT Act 2000/2008
§
Information Security (Policies & Safeguards)
§
Whistle blower policy & Integrity Pact
§
Case studies and group discussion
§
Section 45 in Insurance & Due Diligence
Participants Profile:
§
Officers in the cadre of A.D.M. and above to be
nominated by the respective Zonal HRDs
§ Faculty Members of ZTCs and MDC to be nominated by respective ZO HRD and CO HRD
Trainees nominated for this programme in the last two years should not be renominated.
Duration:
3 days
I.
02.06.2025 - 04.06.2025
II.
28.07.2025 - 30.07.2025
III.
29.09.2025 - 01.10.2025
IV.
08.12.2025 - 10.12.2025
V.
28.01.2026 - 30.01.2026
VI.
04.03.2026 - 06.03.2026