Fraud Investigations

Level: Intermediate

Why you need this course:
After completing this course, you’ll be able to evaluate a suspicious claim.

Upon successful completion of this course, you should be able to:

• Describe the federal and state laws regarding fraud.
• Given a claim situation:
• Identify indicators of fraud.
• Identify industry resources and state and local resources used in fraud investigations.
• In an arson claim:
• Explain under what circumstances an arson defense would be successful.
• Identify the policy provisions used to support an arson defense.
• Distinguish between the burden of proof in a civil lawsuit and a criminal lawsuit.
• Explain how a fire’s origin and cause are determined.
• Explain the role of the members of an arson team.
• Explain how to evaluate suspicious burglaries and thefts.
• Explain the purpose of a special investigation unit (SIU) and the appropriate use of the SIU in a claim investigation.

Cost: $20 per Professional Development Hour (PDH). Information on Professional Development Hours (PDH) provided can be found here.

Fraud Investigations Topics Include:

• Federal and state laws regarding fraud
• Indicators of fraud and industry, state, and local resources used in fraud investigations
• Arson claims
• Determining a fire’s origin and cause
• The role of the members of an arson team
• Evaluating suspicious burglaries and thefts
• The purpose of a special investigation unit (SIU) and the appropriate use of the SIU in a claim investigation

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