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AntiFraud

All claim professionals need to be alive to the issue of insurance fraud and the investigation of such claims requires appropriate knowledge and skills.

All claim professionals need to be alive to the issue of insurance fraud and the investigation of such claims requires appropriate knowledge and skills. The CILA Anti Fraud SIG committee brings together a group of experienced members whose core activity is the consideration and investigation of potentially fraudulent claims. In addition to providing CILA members with technical material on fraud matters, the group also actively contributes to insurance industry discussions and anti fraud initatives by sharing their extensive, first hand knowledge and experience of fraud investigation.

SIG Committee

Chairman

Bobby Gracey
Charles Taylor Adjusting


Members

Ian Carman
Sedgwick International UK

Steven Crystal
Sedgwick International UK

Neil Daniel
Harris Balcombe

Brendan Gillooly
Quadra Claims Services Ltd

Chris Lee
Crawford & Company

Marie Quinn
Woodgate & Clark

Garry Slater
Claims Consortium Group


SIG Sponsor

Latest updates

Anti-Fraud SIG Webinar – ‘Fraud and Property Claims’

On Wednesday 1st and 8th March, Neal Davies-Fletcher delivered a 2-part webinar entitled ‘Fraud and Property Claims’ which was attended by over 100 CILA members worldwide. Both webinars covered fraud aspects of the CILA Advanced Diploma syllabus including:

  • What is fraud?
  • Claims investigation
  • Standard of proof
  • Investigation outcomes
  • Remedies available

Please find copies of both presentations below, as well as an Anti-Fraud paper written by Neal,
to aid exam candidates with their revision.

Downloads
Fraud and Property Claims Presentation (Part 1) (1.91 MB)
Fraud and Property Claims Presentation (Part 2) (1.86 MB)
Fraud and Property Claims Paper – Neal Davies-Fletcher (1.86 MB)

Fraud investigators from the CILA Anti-Fraud SIG committee discuss the financial impact of covid-19 on businesses and how this may lead to commercial insurance fraud.

The paper considers fraud statistics, the UK economy and the challenges for businesses. The writers use real life examples to demonstrate how a business may exaggerate or fabricate an insurance claim. They also provide some insight into the types of action that can be taken to combat fraud and the important role that claims handlers and loss adjusters have.

On Wednesday 1st and 8th March, Neal Davies-Fletcher delivered a 2-part webinar entitled ‘Fraud and Property Claims’ which was attended by over 100 CILA members worldwide. Both webinars covered fraud aspects of the CILA Advanced Diploma syllabus including:

  • What is fraud?
  • Claims investigation
  • Standard of proof
  • Investigation outcomes
  • Remedies available

Please find copies of both presentations below, as well as an Anti-Fraud paper written by Neal, to aid exam candidates with their revision.

pdfFraud and Property Claims Presentation (Part 1) (1.91 MB)

pdfFraud and Property Claims Presentation (Part 2) (1.86 MB)

pdfFraud and Property Claims Paper – Neal Davies-Fletcher (1.86 MB)

This report provides the results analysis of the Anti Fraud member survey 2013

The Data Protection Act 1998 (DPA) is based around eight principles of good information handling. These give everyone specific rights in relation to their own personal information and place obligations on those organisations that are responsible for processing it.

A criminal offence is created under section 56 of the DPA, commonly known as ‘enforced subject access’. This will occur where a person wishes and requests to see another individual’s criminal record, but chooses not to use the legally approved system.

Downloads

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Have a look in the CILA Technical library. Papers and presentations that were previously produced by our SIGs are often filed there for the benefit of members.

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