Insurance Fraud Risk Governance Training Course

Course Overview

Learning Objectives

• By the end of the course, participants will be able to:
• Analyze the nature and sources of fraud risk across insurance organizations.
• Assess the financial, operational, regulatory, and reputational impact of insurance fraud.
• Develop an integrated governance framework for managing insurance fraud risk.
• Define the roles and responsibilities of the Board, executive management, risk, compliance, internal audit, and business functions.
• Apply structured methodologies for assessing and prioritizing fraud risks.
• Develop fraud risk registers and risk-control matrices.
• Evaluate fraud vulnerabilities across underwriting, claims, distribution, collections, and payment processes.
• Design key fraud risk indicators and early-warning mechanisms.
• Strengthen fraud reporting, escalation, investigation, and response processes.
• Assess the effectiveness of preventive, detective, and responsive fraud controls.
• Develop management and Board-level reporting frameworks for fraud risk oversight.
• Identify root causes and control weaknesses contributing to recurring fraud events.
• Strengthen third-party, broker, agent, and service-provider fraud risk management.
• Integrate fraud risk governance with broader enterprise risk management and organizational resilience.
• Establish continuous improvement mechanisms for the insurance fraud risk management framework.

Who Should Attend

Learning Outcomes

• By the end of the course, participants will be able to:
• Explain the principles of fraud risk governance within insurance organizations.
• Identify major fraud risks throughout the insurance product and policy lifecycle.
• Conduct structured insurance fraud risk assessments.
• Link fraud risks to enterprise risk appetite and strategic objectives.
• Define governance responsibilities across the three lines of defense.
• Evaluate the effectiveness of fraud prevention, detection, and response controls.
• Identify fraud indicators and unusual patterns across insurance processes.
• Develop early-warning indicators and fraud risk dashboards.
• Strengthen fraud escalation, investigation, and reporting mechanisms.
• Assess fraud risks associated with brokers, agents, service providers, and other third parties.
• Evaluate fraud vulnerabilities created by digital insurance channels and automated processes.
• Prepare meaningful fraud risk reports for senior management and Board-level committees.
• Identify control gaps and develop practical remediation plans.
• Establish a structured framework for continuous improvement of fraud risk governance.
• Apply an integrated fraud risk governance model to realistic insurance scenarios.

Course Outline