The CLAIMS FRAUD FUNDAMENTALS course is intended for SIU and insurance claims personnel either new to the insurance industry or new to the task of investigating suspicious claims. The course covers the basics of insurance claims law as they relate specifically to recognizing and investigating suspicious claims. It’s a natural lead-in to AEI’s seven- course Program – Law of Claims Fraud Investigation and Defense.
025 CLAIMS FRAUD FUNDAMENTALS
(Course Textbook Consists of 120 Pages)
This course provides the new SIU investigator with an understanding of the principles of insurance law necessary for effective investigations. The course introduces the student to concepts of insurance claims law as they apply to the investigation and defense of suspicious claims.
Combining elements of insurance coverage and legal principles, the course covers the rights and responsibilities of the insurer, insured, and third parties. The course will allow the student to see at once how the law impacts the investigation of suspicious claims and how to investigate suspicious claims within the boundaries established by the insurance policy as interpreted by actual court cases.
1. Fraud as a Policy Defense
2. Special Investigation and The Law
3. Insurance Fraud and Criminal Prosecution
4. Issues of Legal Proof