WORKBOOK
Examining and Investigating Foreign Life Insurance and
Accidental Death Claims: The Workbook
COURSE CONTENT
Course 1: CLFI200 – Insurance and Biology
Principles and Practice of Insurance
Types of Life Insurance
Human Anatomy and Physiology
Course 2: CLFI300 – Examining Life Insurance and
Accidental Death Claims
Policies’ Terms and Conditions
Types of Life Insurance
Reviewing the Claim Form
Reviewing the claim documents
- Medical Certificate of Cause of Death
- Police documents (Extract, FIR, Abstract, and Report)
- Burial Permit
- Cremation Certificate
- Certificate of Death or Death Certificate
- The obituary poster (including newspaper advertisement)
- The printed funeral program
- Photographs of the funeral ceremony
Course 3: CLFI400 – Conducting on-site investigations
Application of French and Spanish for English language speakers
Reviewing the claim documents and investigative strategies
Writing letters for the hospital, civil/deaths registry, and the Police
Inquiries at the hospital / Examining the Medical Certificate of
Cause of Death
Investigating age of the policyholder
Inquiries with the Police / Examining police documents
Inquiries about sworn affidavits / Examining sworn affidavits
Inquiries at the civil/deaths registry / Examining the Death Certificate/
Examining the Cremation Certificate
Burial or Cremated / Inquiries at the burial site or the crematorium
Different scenarios: MVA/RTA, sickness, drowning, disappearance
Interviewing the neighbors
Drafting a Questionnaire / Statement form
Interviewing the claimant and / or the family of the policyholder
What proves a foreign death claim?
Course 4: CLFI500 – Nature of fraudulent claims
Nature of fraudulent foreign death claims
Fraudulent creation of claims
- Insured or policyholder does not exist
- Documents do not support alleged death
- Body substitution
Concealment of material information to receive coverage
Misrepresentation of material information to receive higher payments
Fraud perpetrated in connivance with insurance agents
Course 5: CLFI505 – LESSONS TOWARDS FULL
CERTIFICATION
Report Writing
Ethics of Professional Practice
Instructing and working with the professional investigator – The benefits
of working as a Certified Life Insurance Fraud Investigator (CLFI) or
Certified Life Insurance Anti-Fraud Consultant (CLAC) or the Certified
Life and Health Insurance Fraud Investigator (CLHFI) or the Certified
Life and Health Insurance Anti-Fraud Consultant (CLHAC).
Role of the insurers’ Claims Examiners in effectively communicating
the investigative result.