CPD: Insurance fraud
- To be confirmed
- 17:00–19:00 CET
While fraud is next to impossible to eliminate (especially in the Insurance Industry - which is based on trust), the management of fraud together with legal safeguards make it possible to monitor, detect and control its occurrence. This short seminar will give an insight into types of insurance fraud and provides an outlook on typical symptoms associated with this criminal activity. Case studies will serve to enlighten those within the insurance field and will propose how to act effectively.
What is insurance fraud?
- Legal definition of fraud: we will look at the Criminal Code, and see what it has to say about fraud. What are the component elements of fraud? How is it committed?
- Insurance fraud
- Fraud committed by insurers, including premium diversion and other fraudulent practices
- Fraud committed by insured clients
- Fraud committed through false insurance claims
We will look at each of these kinds of fraud and see what they mean and the methods in which they are committed.
- Hard fraud / soft Fraud: what is the difference? How does this occur?
- How to detect fraud and how to build a case when fraud is suspected.
- Taking fraudulent claims to court: what is the procedure? What difficulties are typically encountered?
- Case studies. We will look at two judgements tackling false insurance claims and how the court has handled such claims.
- Q&A session
Fraud is an inherent element of trade; it is a risk that anyone who operates a business needs to face. While it is impossible to operate in a completely fool-proof manner, because the cost of doing so in terms of resources is prohibitive, all businesses need to take a proactive approach in investing in systems and practices that minimise the risk of fraud. This includes the training of management and personnel who are made aware of these risks and learn how to take precautionary action to avoid falling prey to fraud.
Individuals who wish to become more familiar with conduct regulation, including those who have started to pursue a career in insurance, distributors of insurance products, individuals forming part of key functions in insurance entities such as compliance and risk. Needless to say, it is ideal for those working in the claims department and also those underwriting insurance.
Dr Michael Zammit Maempel
Trainer(s) bio and experience
Dr Michael Zammit Maempel is a law graduate of the University of Malta (2001), and subsequently read for his Masters (LL.M.) in Computers & Communications Law at Queen Mary University of London (2016). After having worked for several years with GVTH Advocates (today GVZH Advocates), one of Malta’s top tier law firms, where he set up the firm’s practice in technology law and data protection, he moved on to set up his own niche consultancy ‘Maempels’ in 2016 in order to practice in those areas of law over which he has always been passionate and his practice now focuses exclusively on media and technology law, intellectual property and data protection. Over the years he has advised some of Malta’s foremost businesses, including telecom operators, airport terminal operators, casino operators, credit agencies and operators in the hospitality industry on data privacy issues in the context of other, usually more complex, corporate issues. He is also the co-author of all three editions of “Data Protection: Jurisdictional Comparisons” published by Thomson Reuters in 2012, 2014 and 2016 respectively as part of their International Series.
Michael is currently the project manager for a team of data privacy legal researchers on the RED-Alert Project (www.redalertproject.eu), which is an EU-funded consortium project currently working on the real-time early detection of online terrorist content.
As of January 2018, Michael is also a certified Data Protection Officer by the European Institute of Public Administration (EIPA) in Maastricht, The Netherlands which offers the only EU officially-recognised certification within the EU’s official institutions and bodies. He also serves as Data Protection Officer to a number of local businesses in Malta.