Robust Fraud Risk Control Framework: Up the Ante in Medical Claims Fraud

18th July 2023 | 9.00 a.m. - 12.30 p.m.
Bangunan AICB, Kuala Lumpur

This seminar focuses on upgrading strategies to combat medical claims fraud. We aim to establish a robust fraud risk control framework aligned with insurers’ zero-fraud strategy. By prioritizing detection, investigation, deterrence, and prevention, we’ll fortify fraud defense and its contributing success factors.

Key Highlights:
  • Introducing a novel fraud scorecard format for accurate performance indicators, allowing retrospective analysis and future fraud threat forecasting.
  • Plotting a roadmap to fraud resilience, embracing automated anti-fraud technologies and addressing weaknesses in fraud controls.
  • Discussing investment areas and fraud KPIs embedded in incentive systems.
  • Highlighting forward-attacking fraud defense and robust investigation methods to control and mitigate excessive claims fraud losses.
  • Emphasizing prevention, deterrence, and the importance of evidence-based fraud dossiers for favorable financial outcomes.
Join us to explore effective strategies for detecting, preventing, and investigating medical claims fraud. Together, we’ll strengthen our defense against fraudulent activities in the medical insurance industry.

Speaker Profile

Rudolf Frei

Rudolf founded IBNR in 2009, a group of privately owned management consultancies specialising in structural and performance reviews of claims and fraud processes, project executions, and claims IT and fraud analytics solutions.

He was instrumental in establishing international benchmarking reviews of key claims and fraud performance indicators.

He supervised a special investigation anti-fraud unit for over 4 years as head of claims and legal, and SIU

Contact Info

The Malaysian Insurance Institute 197701004772 (35445-H),
Level 6, Bangunan AICB,
No. 10 Jalan Dato’ Onn,
50480 Kuala Lumpur, Malaysia 

Tel : +603 2712 8882

Email :

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