Insurance Fraud in the Age of Artificial Intelligence *New Course 2026

Description

Insurance fraud affects every line of insurance and costs the industry and consumers billions of dollars each year. Fraudulent activities range from exaggerated claims and staged accidents to complex organized schemes involving multiple participants. In recent years, advances in artificial intelligence and digital technology have created new opportunities for both committing and detecting insurance fraud.

This course provides insurance professionals with a comprehensive overview of insurance fraud across multiple lines of coverage, including property and casualty insurance, life insurance, health insurance, disability insurance, and workers’ compensation. Participants will explore common fraud schemes such as staged automobile accidents, arson-for-profit, medical billing fraud, false disability claims, premium fraud, and identity theft.

The course also examines the growing role of artificial intelligence in the insurance industry. Participants will learn how insurers are using advanced analytics and AI-powered tools to detect suspicious claims patterns, identify fraud rings, and improve investigative efficiency. At the same time, the course will discuss how criminals are increasingly using technology—including synthetic identities and digital manipulation—to perpetrate fraud.

Through real-world case studies, fraud indicators, and ethical guidance, insurance professionals will gain practical knowledge to recognize potential fraud and support efforts to protect consumers and the integrity of the insurance marketplace.

Learning Objectives:
At the conclusion of this course, the participant will be able to:
 Define and differentiate types of insurance fraud, including hard fraud, soft fraud, opportunistic fraud, and organized fraud across multiple lines of insurance.
 Identify common fraud schemes across all major lines, including property & casualty, auto, life, health, workers’ compensation, and disability insurance.
 Explain the financial, operational, and consumer impacts of insurance fraud on the insurance industry and the broader economy.

 Recognize fraud red flags and risk indicators during the application, underwriting, and claims processes.
 Describe the role of artificial intelligence in both committing and detecting insurance fraud, including emerging risks such as synthetic identities and deepfake documentation.
 Apply ethical standards and understand legal responsibilities, including proper documentation, reporting obligations, and the consequences of fraud for insurance professionals.