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Examining and Investigating Foreign Life Insurance and Accidental Death Claims: The Workbook

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.