Life Insurance Fraud Prevention Fundamentals

In an era of increasingly sophisticated financial crime, life insurance remains a high-value target for fraudsters. This workshop provides a comprehensive foundation in identifying, preventing, and managing fraud throughout the policy lifecycle—from initial application to the final claim payment.

Participants will explore the “Fraud Triangle” (Pressure, Opportunity, and Rationalization) and apply it to real-world life insurance scenarios. By the end of this session, attendees will be equipped with the “red flag” recognition skills and investigative techniques necessary to protect their organizations and legitimate policyholders from the rising cost of fraud.

At the end of this session, participants will:

• Define the legal and regulatory definition of life insurance fraud and its economic impact on the industry.
• Identify common fraud typologies, including application fraud, faked deaths, and "ghost broking."
• Recognize red flags across the customer journey, from non-insurable interest to suspicious medical documentation.
• Apply a risk-based approach to investigating questionable claims while maintaining a positive customer experience for legitimate claimants.
• Execute proper reporting and whistleblowing procedures in alignment with internal policies and local regulations.

Mr. Ulric Miller is certainly no stranger to the Insurance Industry and has over 45 years’ experience. More specifically, his role as a TTII lecturer and trainer has spanned a diverse range of subject areas namely Long-term Insurance Business, AML/CFT/CPF, Strategic planning and Ethics. His historical roots run deeply in the TTII, as he also served as President of the Council of Trustees. Regionally, he has held the position of 1st Vice President of the Association of Insurance Institutes of the Caribbean (AIIC). He has also served as an adept change manager with special experience in leveraging IT, possesses a highly successful track record in Customer Relationship Management, Strategic Management and Scenario Planning. His unwavering dedication to leadership and management is reflected in his service as a member on various state and private boards. Mr. Miller holds the designation as a Fellow of the Life Management Institute which demonstrates his in-depth knowledge and expertise in the field of long-term insurance management. Among his other accolades are Certified Anti-Money Laundering Specialist (CAMS) and Associate in Insurance Regulatory Compliance (AIRC).