Course in Insurance Crimes Investigation (77204)

Content: The following knowledge is embedded within the module, and will be assessed directly or indirectly through the assessment of the specific outcomes in terms of the assessment criteria: Insurance law long-term insurance An introduction to long-term insurance Formation of long-term insurance contract Concepts of good faith, insurable interest, materiality, and misrepresentation Clauses in a long-term insurance policy Types of long-term insurance crimes Long-term insurance processes and terminology Long-term insurance terminology Underwriting and sales, various products Premium collection Claims processes, claims registration, assessments, claims settlements

Content: The following knowledge is embedded within the course, and will be assessed directly or indirectly through assessment of the specific outcomes in terms of the assessment criteria: Insurance law short term insurance An introduction to short-term insurance Formation of short term insurance contract Concepts of good faith, insurable interest, materiality, and misrepresentation Clauses in a short-term insurance policy Identify the types of short term insurance crimes Short term insurance processes and terminology Short term insurance processes and terminology Short term insurance terminology Underwriting and sales, various products (all risks, buildings, contents, marine, agrietc) Methods of sales (Direct vs Broker) Premium collection Claims processes Role players in the claims processes Technology used in the short term insurance claims processes Report Writing Elements of report writing Aspects of short term insurance crime Impact of short term insurance crime Types of short term insurance crime Common characteristics of opportunistic and organised short term insurance crime Prevalent insurance crimes committed amongst the various short term insurance role players (policyholders, brokers, employees, suppliers, or no relationship) Emerging insurance crime trends Identifying sources of information Management of short term insurance crime investigations Developing a repository of short term insurance crime scenarios Converting reactive short term insurance crime investigations to proactive intelligence driven investigations to proactive intelligence driven investigations through scenario testing Short term insurance crime investigation resources Investigation of short term insurance crimes

Content: This module is designed for students in the insurance sector. It aims to develop or expand their knowledge and competencies in the investigation of insurance-related crimes in both short- and long-term insurance. This module covers the following themes: Introduction to Insurance, Insurable Interests, Categories of Insurance, Stakeholders and Role players in the Insurance Industry, Legislative Framework for Insurance Service Providers, Types of Insurance related crime, Generic Investigative Methodology for flagged claims and report writing. This module focuses on the general investigation competencies required within the short- and long-term insurance Industry. The focus is on the practical investigative duties and activities of an insurance crime investigator. Furthermore, the course will be beneficial for people already working as Loss Adjusters within the broader Insurance space as well as those who are interested in considering starting a career in the insurance industry as an investigator. The following knowledge is embedded within the module and will be assessed directly or indirectly through the assessment of the specific outcomes in terms of the assessment criteria: Introduction to Insurance, why it is needed, and what an insurable interest is: Categories of Insurance Property/casualty (Automotive, home and business or commercial) Life/health (Life insurance and Annuity) Legislative framework of the Insurance Industry Primary role players and stakeholders in the Insurance Industry Criminal offences related to the Insurance Industry Generic investigative process of a flagged claim Report writing