IAI SP6 case studies
IAI SP6 · Put your knowledge to work in context.
SP6 is a specialist module of the Insurance Institute of India (IAI) focused on insurance fraud: how it is defined and classified, the legal and regulatory framework that governs it, the red flags that appear in underwriting and claims, investigation and evidence handling, interviewing and statement taking, fraud risk management and controls, data analytics and detection technology, and the ethical and professional standards expected of a fraud examiner. It suits claims handlers, underwriters, fraud investigators, compliance and risk staff, and internal auditors who need a structured, India-specific grounding in detecting, investigating and deterring insurance fraud. The IAI SP6 case studies are 5 cases and about 4,851 words.
1The 12-vehicle fleet that did not add up
Meridian Commercial, a broker, submits a new-business commercial combined proposal for a haulage fleet: 12 tractor units and 14 trailers, all registered at a residential address in a town with no yard or operating centre declared. The proposal states 60,000 km per vehicle per year and three named drivers with nine or more years' experience, but the driver schedule attached lists 19 names.
1,004 words, about 5 min2The €48,300 escape of water
A household policy incepted 19 weeks ago. The policyholder, a property developer, reports escape of water from a pipe beneath the kitchen floor of a house he bought at auction seven months ago.
980 words, about 5 min3The broker who could not tip off the client
You are the financial crime and compliance lead at a regional broker. During a routine file review of a commercial motor renewal you find an email chain.
977 words, about 5 min4The interview that began as an accusation
Eight months after a low-speed rear-end collision, a claimant submits a soft-tissue injury claim supported by a medical report describing restricted neck movement and an inability to lift heavy objects. The insurer's surveillance shows the claimant loading shopping bags into a car, lifting a toddler, and attending a gym session where she uses a rowing machine.
941 words, about 5 min5The analytics cluster
A personal injury insurer's new network-analytics model flags 62 claims in 90 days, clustered around three repairers and two medical clinics. The model uses claimant postcode, payment method, time of claim submission and links between phone numbers.
949 words, about 5 min