What You Will Learn!
- Explore how the fraud perpetrator’s use of the covenant of good faith and fair dealing to defeat insurer’s claim of attempted insurance fraud.
- Recognize the elements insurance fraud and the proof needed to assert fraud as a defense.
- Identify what investigation will be performed to stop fraud.
- Explore how the statutory requirement to thoroughly investigate potential fraud makes successful fraud difficult.
Description
This course explains how insurers, insurance adjusters, and insurance special investigation unit investigators work to prevent insurance fraud (obtaining funds from an insurer wrongfully and illicitly). It explains staged losses, fake thefts, paper property, arson for profit, false documentation, and other efforts to defraud an insurer. The course also explains what is necessary to prove fraud as a defense to an insurance claim.
The course covers the following:
- The use of investigators to gather evidence establishing that a fraud is being attempted.
- The various types of fraud attempted against first party property policies.
- Understanding the staged accident.
- Understanding the use of paper property.
- How to discover an arson for profit.
- How to prove that an insured is involved in an arson for profit.
- How to discover health insurance fraud.
- How to recognize professional conspiracies.
- How to recognize fraud in the legal profession.
- How to act in good faith and fair dealing with regard to insurance fraud.
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