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Contents Claims: Hard Fraud / Soft Fraud

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The Contents Claims: Hard Fraud and Soft Fraud course is designed to help adjusters enhance their knowledge, understanding, and professional competence of homeowners insurance coverage principles involving fraudulent contents claims. The module is presented by Andrew P. Rock, Esq. of The Rock Law Group, P.A. and Gregory Nelson, Insurance Consultant.

This course is designed to provide claim teams with a solid background and foundation for attacking and dealing with contents fraud. The course begins with an overview of the program, and a discussion of hard fraud versus soft fraud. It then examines specific examples of insurance fraud and scenarios with a focus on contents fraud. Next, the course addresses insurance fraud statistics that provide context for the extent of the problem, and justify giving the resources necessary to fight fraud. Then, the course identifies the unique characteristics of fraudulent contents claims. The course also addresses some of the difficult issues encountered in proving fraud, including establishing intent. Finally, the course concludes with fraud case studies- real-life examples of contents fraud and how courts have dealt with these issues.

After completing the course, the attendee will be able to compare hard fraud and soft fraud; identify effective means of detecting fraud; utilize new tools for dealing with fraud; implement effective defenses based on fraud, concealment, and misrepresentation; identify applicable policy provisions; and defend the denial of a fraudulent contents claim. The course is primarily designed for insurance professionals working in the area of property adjusting.

What CE Credit is available?

Note: To qualify for credit, you must submit completion (including a passed final exam if required) within five days of completing the last quiz. No partial credits will be awarded.

State:
Adjuster General CE Hours:
Adjuster Ethics CE Hours:
Attorney General CLE Hours:
State's Course ID:
NH 2.0 6000066508
TX (classroom equivalent) 2.0 General 123187
FL * ( Provider Number: 364169 ) 2 Hous Optional 1198947
IL 2.0 600613
WY 2 General 31334
OK 2.0 General 6000067604
NC 2.0 212261

* This course has been approved by the Florida Department of Financial Services for insurance continuing education credit.

Course Content

Introduction (Contents Claims)
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Lesson Content
  1. Introduction to Topic & Presenters
  2. Hard Fraud & Soft Fraud Defined
  3. Examples of Insurance Fraud
  4. Potential Red Flags for Fraud
  5. Applicable Policy Provisions
  6. Fraudulent Claim Scenarios Involving Different Perils
    1. Fire Loss
    2. Theft Loss
    3. Water Loss
    4. Catastrophe Loss
  7. Key Claim Considerations
  8. Recap
Scope of Insurance Fraud
Expand
Lesson Content
  1. Fraud Statistics & Impact
  2. Fraud Motivators
  3. Determining Intent
  4. Fraud Investigation Techniques
  5. Interacting with Public Adjusters and Contents Specialists
  6. Recap
Investigating Potential Contents Fraud I
Expand
Lesson Content
  1. Examples of Contents Fraud
  2. Indicators of Potential Contents Fraud Among Various Claim Scenarios
  3. Recap
Investigating Potential Contents Fraud II
Expand
Lesson Content
  1. Indicators of Potential Contents Fraud Among Various Claim Scenarios
  2. Combating Insurance Fraud
  3. Claim Denial Considerations
  4. Recap
Issues with Proving Fraud
Expand
Lesson Content
  1. Proving Fraud
  2. Establishing Intent to Defraud
  3. Claim File Considerations & Bad Faith Allegations
  4. Recap
Case Studies (Contents Claims)
Expand
Lesson Content
  1. Fraud Case Studies
    1. Bankruptcy Implications
    2. Insurance Application Considerations
    3. Additional Living Expenses & Fraud
    4. Policy Provision Implications
  2. Course Review
  3. Final Fraud Tips & Takeaways
  4. Recap
Get CE Credit or Certificate of Completion.

Submit within 5 days to get CE Credit or Certificate of Completion.

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