About The Course
The impact of the pandemic is seen across businesses around the world including insurance business. Increase in the number of hospitalization and death cases has led to a sudden rise in health and life insurance claims, which also created a sudden demand in both life and health insurance coverage for individuals and family members. With the rising number of new businesses, comes the rise in insurance frauds.

During pre-pandemic, insurers were getting adept at managing abuse/fraudulent claims in cases like acute febrile illness, gastroenteritis, dengue, and malaria. Using high ended antibiotics even for viral ailments was rampant in inflating the bills. Circa March 2020; come Covid 19 and the beginning of chaos. Providers were cashing in on fear of consumers and instances of unnecessary hospitalizations, irrational investigations, use of high ended antibiotics (expensive ones) for a viral condition, prolonged length of stay etc. lead to very high abuse and fraud.

This course on Managing Covid Claims & Frauds pertaining to Covid, will help insurance professionals become aware of insurance frauds pertaining to Covid hospitalization and hence help them in curbing these.

Key Learning Outcome:
At the end of the course, participants will be able to:

  • Manage Covid-related claims with better insights and reduce instances of abuse thus ensuring cost containment.
  • They will understand to apply national and international guidelines on classification of uncomplicated and complicated cases
  • Get insights into clinical profile of Covid, likely complications, their management - investigations and the interpretation of the same
  • Gather insights what PED predisposes to poorer outcome/ mortality
  • Utilise this knowledge and insights to identify red flags in individual claims and establish abuse/ fraud
  • Raise legible queries to the providers

Course Content:
  • COVID 19 Fever
  • COVID 19 - Confirmed vs Empirically-treated Covid
  • Justifications of hospitalization
  • Rational investigations
  • Rational treatment as per prevailing national guidelines
  • Rational discharge planning

Target Audience
Claims personnel / fraud managers in Health Insurance, life insurance claims personnel and anyone interested to learn about health claims.

Speaker Profile
Dr C H Asrani
DNB (Family Medicine); PGD Medicolegal Systems Adv. Dip in Forensic Medicine & Toxicology CEO, Founder – INCHES’ group of companies

A renowned expert in this area, Dr Asrani pioneered medical audit in insurance in India. With over 300 presentations in insurance risk management, Dr Asrani has been conducting training across Dubai, Bangkok, Kuala Lumpur and Singapore. He also has the distinction of being associated with the National Health Authority (Ayushman Bharat scheme), consulting with The World Bank and being a panelist on various talks on monitoring, audit, and fraud surveillance in the Insurance industry.

He is also one of the first medico entrepreneur to devise cloud-based fraud prevention solutions for insurance companies in India (www.inches-insuretech.com). He is now on an expansion drive to extend his company’s service innovative solutions internationally.

The solutions include medical insights for underwriting, rational claim adjudication, medical processes architecture, clinical audit of claims & underwriter or claim assessor trainings. Dr Asrani’s group of companies have also developed Intelli-Claims, a proprietary tool for medical adjudication of claims using standard treatment guidelines and rule-based analytics.

Date and Time
Date: 26 September 2022
Time: 10.00 a.m. - 4.00 p.m.
Registration Closing Date: 25 September 2022

Price
Early Bird (Register before 12 September 2022)
MII Member: RM370 (Single), RM340 (Group)
Non Member: RM500 (Single), RM470 (Group)
International: USD140 (Single), USD120 (Group)

Normal Fee
MII Member: RM430 (Single), RM400 (Group)
Non Member: RM570 (Single), RM540(Group)
International: USD150 (Single), USD135 (Group)


    Download Brochure         Register Now    

For more information about MII’s virtual programmes, visit our #VirtualLearning microsite
or call us at +603 2712 8882 or email events@mii.org.my / sales@mii.org.my.

Be safe and stay strong.

#EmpoweredLearning
#LearningNeverStops #buildingknowledgetogether

Follow us for latest updates!

Subscribe to MII’s Newsweekly to get weekly updates on MII products, news and promotions via email.
Click here to subscribe.