III IC-39 case studies
III IC-39 · Put your knowledge to work in context.
IC-39 Fraud Risk Management in Insurance is one of the paper-based subjects listed by the Insurance Institute of India (III) in its Professional Examination catalogue, alongside topics such as health insurance claims management, general insurance underwriting, and marine insurance. The Institute publishes study material for IC-39 in English and sells it through its Study Material section in hard copy, e-book, and audio book formats. The III IC-39 case studies are 5 cases and about 4,103 words.
1The Body Shop Cluster: Pattern Referral Under a Threshold Rule
You are the fraud risk lead at a mid-sized private motor insurer with 1.2 million policyholders. Q3 analytics flagged a 14% rise in third-party injury claims in one metropolitan region.
757 words, about 4 min2The MGA Micro-Business Book: Fraud, Underwriting Failure, or Both
You are head of financial crime at a specialty insurer. Eleven months ago an MGA launched a micro-business package; it now writes 18 million GWP across 2,300 policies with a 118% loss ratio.
811 words, about 4 min3The Backdated Inception: Internal Override and Broker Proximity
A claims quality reviewer at a commercial property insurer is checking a 900,000 fire claim from a restaurant. The policy was issued on 14 March; the fire occurred on 11 March; the declarations page shows an inception of 6 February.
830 words, about 4 min4The Non-Disclosed MRI: Materiality, Remedy and the Producing Agent
A 52-year-old policyholder dies of a glioblastoma 14 months after taking out a 750,000 twenty-year term policy. Underwriting was non-medical because the sum assured sat below the 1 million fluids threshold.
865 words, about 4 min5The 1099 Payroll Audit: Premium Fraud or Contract Dispute
A workers' compensation carrier completes a post-policy premium audit of a construction staffing company writing 4.2 million in annual premium across three states. A sample of 30 of 210 worksites shows 62 workers paid as 1099 subcontractors who never appeared on the reported payroll.
840 words, about 4 min