We had no way to know or prepare for the devastating impact of COVID19! The insurance industry is vulnerable to fraud in general and COVID19 related health claims pose a special risk!

Training mitigates fraud! This course was created for medical assessors, insurance claims assessors or insurance adjustors who work with health-related insurance products. COVID 19 is a growing reality and has already impacted the insurance industry globally. The material in the following lectures will assist you in assessing claims for COVID 19 admissions to determine the validity of the claim and to identify red flags that could indicate irregularities, abuse and potential fraud. Fraud occurs in various forms within the insurance industry and the global pandemic may be exploited for the purpose of committing fraud in one specific area that we identified.

By focusing on how COVID 19 is diagnosed, treated and managed the claims assessor is equipped to identify red flags that will make assessment effective and potentially prevent fraud from being committed. Red flagging at the claims stage is critical for the identification and remains the most effective method of prevention of health-related insurance fraud. The information contained in this course can be applied to hospital cash back insurance products, medical aide or medical scheme claims or illness and disability claims and in claims where the length of admission or severity of the disease impacts the quantum or value of the claim.

No prior medical training is required and the information in the course can be applied to claims the world over. This is an all level course, beginner to advanced will find value in this course.