Life, Health & Disability Fraud

LIFE, HEALTH & DISABILITY FRAUD COURSES


NATG offers multiple courses for the Life, Health and Disability Insurance Professionals. All of our courses can be customized to meet your company's specific needs.



Life & Disability Fraud
This course will provide the student with a thorough knowledge of the various disability and life insurance products available today, the laws that affect them, the benefits and options available with each, and the vulnerabilities and opportunities for fraud.

By laying a foundation of product understanding, the course prepares the student for recognizing, combating, and even deterring insurance fraud in these lines.  Students will be provided with real-world examples, terminology, red flags, and investigative techniques for front-end (premium and application) fraud, claimant/beneficiary fraud, and get-rich-quick schemes.  Completion of this course provides students with an intermediate-level understanding of all aspects of life and disability insurance fraud.

Health Care Fraud
Healthcare Fraud, as defined by the National Health Care Anti-Fraud Association (NHCAA), includes - the deliberate submittal of false claims to private health insurance plans and/or tax-funded programs such as Medicare and Medicaid.

This course will identify what health care fraud is, how much it is costing the industry and all U.S. individuals. We will show explain how health care fraud is being committed, the schemes organized by providers, insureds and organized groups. We will advise on some factors that are causing our society to commit fraud as well as providing you how to investigate and identify health care fraud.

Annuity Fraud
Annuities are one of the more convoluted concepts within the world of financial planning. It is imperative that agents have a thorough understanding of exactly what it is that they are offering to sell. Even though many products are called "annuities," the differences between individual plans are vast.

Since the Annuity product is considered an Insurance Product, Insurance Fraud can occur if a misrepresentation has occurred in the sales process. This course differentiates between the "Agent Language" vs. "Client Language". The course also discusses the areas that are considered fraudulent as well as providing examples and true cases of annuities gone wrong.

Viatical Fraud 101
First there were viatical settlements. Then there were senior settlements. Then there were life settlements. Throughout the years, there always was fraud. As the industry grew, viatical fraud grew-in numbers of victims, in dollar amount, and in the variety of fraud. Today it is more complex than ever.

This course will provide  the employee with the history of viaticals, the schemes often targeting the elderly, how and why viators profit from the viaticals and the insured does not. We will provide you with information regarding insurable interest, the financing schemes, Fraud & Incontestability and well as negligence & homicide.

Billing & Coding Fraud
Medical Coding is a process that involves the abstraction of a medical document and its conversion into a number found in the industry approved code sets. You will learn what coding is, how the clinics, facilities and doctors abuse the set codes and commit insurance fraud intentionally. You will learn how to identify misused codes, understand what unbundling & re-bundling are, how to negotiate and reduce these bills.

Dental Fraud
This course is an overview of the mysteries of dental injury claims. It is designed to provide claims and SIU personnel with enough information and knowledge to make an informed decision on paying a claim as submitted or opting to further scrutinize it. Employees will learn to read a dental chart and interpret the information that is provided and recognize what information may be missing. You will learn the differences between dental specialties. The different forms routinely used by a dental office.(e.g.,the intake/health history form, the ...treatment planning form, the tooth chart - which shows the existing situation, the dated - treatment log, the periodontal chart, insurance forms, billing forms/protocols. ) You will learn what alternative treatment plans are possible, what excessive Claims are, how items can inflate a claim.