Insurance Fraud Certified - A Professional Designation for PIs

* Requires Completion of the IFC Certification - Level I

You are required to complete the Level I Certification - 10 credit hour certification with a completion score of 70% or higher prior to initiating the Level II Certification.

The Level II Intermediate Certification has three Learning Paths to choose from. Each Learning Path includes a total of 6 hours of Core Curriculum plus 4 hours of specific insurance related curriculum. $200.00

You select which path you take from the Option Paths.

IFC - Level II- Core Curriculum

Private Investigator Ethics (2 Credit Hour)

This course will provide you with the understanding of what ethics are. This course will provide you with understanding of how ethics relate to insurance and insurance investigations. Conducting an investigation wrongfully, illegally or with bad intent can create a bad faith claim to an insurance company. Professionalism and a strict code of ethics is required by you if you are working a claim investigation for an insurance company. This course will provide you with ways to make ethical decisions and choices as well as providing you with situations and dilemmas for which an investigator may be faced with. We will review several Insurance Laws and Acts that you must understand when working within the insurance industry.

Pretext & Privacy (1 Credit Hours)

This course will provide you with the definition and use of pretexting as it applies ONLY to insurance investigations. You will learn about the Federal and State Laws that protect sensitive and confidential information, as well as case law examples that find pretexting to be invasive, case law examples that find pretexting to be allowable, and examples of company policies regarding pretexting and Ethical Concerns.

Recorded Statements/Interviews & Analysis (2 Credit Hours)

Students taking this course will learn the importance of an effective recorded interview or statement. We will provide you with tips and techniques for best results, including planning of the statement, reviewing of the claim and loss details and planning the interviewee for the interview. We will provide you with a lesson on Communication Skills, doing so by recognizing, reading, and conveying verbal and non-verbal communications. We will provide you with information on how to obtain information effectively for the insurance claim and explain the applications of recorded statements in the claims investigation process.

Neighborhood Canvasses (1 Credit Hour)

This course will discuss how to use a neighborhood canvass in the course of an insurance investigation. We will review how the investigator can obtain valuable information with regards to the subject of the investigation. We will review the reasons for utilizing the neighborhood canvass as well as how to plan and conduct the canvass without breaking any laws or jeopardizing the insurance company you are working for. Finally, we will review what to do at the completion of the canvass. Keep in mind that many insurance claims have to do with injury, which this course emphasizes on. However, many other types of claims can still utilize the same methods and questioning.

Option Path # 1

IFC - Level II- Auto Insurance Path

Auto Theft & The Investigation (2 Credit Hours)

This course will teach you what auto theft is and how it affects the insurance industry. We will discuss how to investigate it on behalf on an insurance claim, provide you with the current trends in theft schemes, and examples of true insurance theft claims. We will also teach you what investigation tools are available to you, and bring you up to speed on all of the anti-theft measures out there today and help reduce auto theft insurance claims.

Staged Automobile Accidents (2 Credit Hours)

This course is a two hour course, providing the insurance professional with knowledge of staged accidents, the common types of staged accidents, how they are performed and how to identify them. •We will provide you with Staged Accident indicators as well as the role of the claims professional will need to perform. The insurance professional will obtain the process and knowledge of a staged accident field investigation. This course will enhance the understanding of the claims professional concerning the parameters of a field investigation and what relevant factors are being collected. This course will utilize intelligence information from subjects who confessed to participating in staged accidents. The curriculum will explain how the claim is set up from policy inception to the date of the actual loss. This will enhance the insurance professional’s knowledge of staged accidents which will facilitate in mitigating the claim.

Option Path #2

IFC - Level II - Life, Disability & Health Insurance Path

Life & Disability Insurance and Fraud (2 Credit Hours)

This course will provide the investigative professional with a thorough knowledge of the various disability and life insurance products available today. It will provide the laws that affect them, the benefits and options available with each, and the vulnerabilities and opportunities for fraud. By laying a foundation of product understanding, this course prepares the student for recognizing, combating, and even deterring insurance fraud in these lines. •Students will be provided with real-world examples, terminology, red flags, and investigative techniques for front-end (premium and application) fraud, claimant/beneficiary fraud, and get-rich-quick schemes. Completion of this course provides students with an intermediate-level understanding of all aspects of life and disability insurance fraud.

Health Care Insurance Fraud (2 Credit Hours)

This course will provide the investigative professional with thorough knowledge of medical and healthcare fraud in both the private and government sectors, the laws that are designed to protect consumers and taxpayers from losses suffered as a result of such fraud, and techniques both the public and insurance/investigative professionals can utilize to combat fraud. •Students will learn current scams committed by both claimants and providers, the effects of this type of fraud, red flags for fraud recognition, and investigative tips. Concepts introduced are illustrated with true-to-life video clips and news articles intended to put these ideas into context. Completion of this course will provide students with an all-inclusive understanding of the scope of this problem, ranging from the most simple situations to complex and sophisticated healthcare insurance fraud crimes.

Option Path # 3

IFC - Level II - Liability Insurance Path

The Concepts of A Product Liability (3 Credit Hours)

This course will provide the student with an overview of product liability and pertinent laws. Issues of product liability are discussed from all points of view, including possible complainants, manufacturers, and sellers. Students will learn on whom the burden of proof lies, when negligence is applicable, what evidence is required, and the legal and implied duties of all parties. Each concept is reinforced and demonstrated in true case studies. Lastly, students will learn effective methods for identification and investigation of possible proof and defense of such claims.

Subrogation & The Investigation (1 Credit Hours)

This course will provide the investigative professional with knowledge of what Subrogation is and how it is utilized within the insurance industry. You will learn the rights of the insurer and insured regarding subrogation within a claim. •We will provide knowledge of how to investigate the common subrogation claim and provide investigation checklists for those investigations.