CIP039 - Fraud Prevention and Awareness

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Last revision date Sep 30, 2019 12:05:04 AM
Last review date Nov 11, 2019 12:15:02 AM

Subject Title
Fraud Prevention and Awareness

Subject Description
Fraud Prevention and AwarenessStudents will learn how fraud may arise under insurance policies and what initiatives the insurance industry had advanced to fight fraud. The cost of fraud is discussed as well as the laws that affect how insurers must handle claims investigations and settlements. Property, liability and automobile claims are covered.
Pre-requisite: CIP013

Credit Status
One credit

Learning Outcomes
Upon successful completion of this subject the student will be able to:

1. Discuss how insurance fraud affects our society, and how consumers generally view insurance fraud and identify strategies that restrict fraud.

2. Define insurance fraud, outline some issues related to proving fraud, and discuss the parts of an insurance contract that help to deter and control fraud.

3. Outline some general principles of law that affect insurance transactions, especially claims investigations, and discuss the concept of good faith.

4. Discuss how brokers, agents and underwriters can be effective in controlling insurance fraud and identify characteristics that should trigger further investigation of a risk to be insured.

5. Discuss information gathered on risks, how it can be used to limit insurance fraud, and discuss alternative types of policies that can discourage insurance fraud.

6. Outline a review program to assess a policy for potential fraud at renewal time and discuss how a renewal policy might involve fraudulent activity.

7. Describe the adjuster's function in managing claims to detect and deter fraud, and outline the key aspects of investigations of suspicious claims.

8. Formulate interview questions, understand the role of experts when investigating claims, and discuss how to prepare to give evidence in court.

9. Identify indicators of arson-for-profit and other fraudulent property claims, and discuss the typical approach taken to defend against claims arising out of arson.

10. Outline the appraisal process and discuss how damage claims may be subject to fraud.

11. Discuss the relationships between parties involved in liability claims and how fraud may arise under liability policies.

12. Identify red flags common to liability claims and discuss the special focus of liability claim investigations.

13. Describe how staged accidents can occur, and outline the aspects of investigating automobile claims to control and prevent fraud.

14. Identify indicators of possibly fraudulent automobile claims and associated injury claims.

15. Discuss the aims and programs of various organizations involved in fraud prevention and control.

16. Discuss the benefits and role of Special Investigative Units.

17. Identify and discuss the codes of ethics and other standards applicable to claims handlers, including privacy guidelines.

18. Discuss the concept of fairness and outline the laws relating to unfair and deceptive acts and practices.

Academic Integrity
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Please visit the Academic Integrity website to understand and learn more about how to prepare and submit work so that it supports academic integrity, and to avoid academic misconduct.

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Accommodation for Students with Disabilities
The College will provide reasonable accommodation to students with disabilities in order to promote academic success. If you require accommodation, contact the Counselling and Accessibility Services Office at ext. 22900 to initiate the process for documenting, assessing and implementing your individual accommodation needs.