Fraud Risk Management in Social Insurance & Designing a Risk Framework

Course Category : Risk Management

A specialised programme focused on analysing fraud risks in social insurance systems and designing a comprehensive risk management framework that strengthens governance, oversight, and financial integrity.
Duration: 5 Days
Level: Advanced

Introduction

Social insurance systems play a vital role in supporting social protection and financial stability. However, the scale and complexity of these systems create increasing exposure to fraud risks, misuse of benefits, and control weaknesses. This course examines structured approaches to identifying and managing fraud risks within social insurance institutions. It focuses on designing a risk management framework that integrates governance, internal controls, and monitoring mechanisms. Participants will learn how to build fraud risk registers, develop risk matrices, and implement effective prevention and response strategies to strengthen organisational accountability and financial integrity..

Targeted Audience

Risk Management Departments and Managers
Internal Audit and Control Units
Compliance and Investigation Teams
Social Insurance and Pension Fund Executives
Governance and Regulatory Officers

Targeted Skills

Fraud risk analysis in social protection systems
Application of structured fraud risk assessment methodologies
Risk management framework design based on international standards
Development of fraud risk registers and risk matrices
Design of preventive and detective internal controls
Fraud response planning and investigation procedures

Expected Outcomes

Develop a comprehensive understanding of fraud typologies within social insurance systems.
Identify and assess fraud risks using structured risk assessment methodologies.
Design a fraud risk register and organisational risk matrix.
Build a comprehensive risk management framework including governance and reporting structures.
Implement preventive and detective internal control mechanisms.
Develop structured fraud response and investigation procedures.

Training Topics Index

Enterprise Risk Management principles based on COSO ERM
Fraud definitions and typologies in the public sector
Fraud risks within social insurance systems
The Fraud Triangle theory

Fraud risk identification techniques
Fraud risk assessment methodology
Developing a fraud risk register
Early warning indicators and fraud red flags

Components of a risk management framework
Risk appetite and tolerance concepts
Roles and responsibilities in risk governance
Aligning fraud risk management with organisational strategy

Preventive versus detective controls
Segregation of duties (SoD)
Authorisation and verification controls
Whistleblowing and reporting mechanisms

Fraud response planning and crisis management
Investigation procedures and documentation
Key Risk Indicators (KRIs) and monitoring systems
Building a risk-aware organisational culture

Course Features

Updated and Interactive Content
Hypothetical Examples and Case Studies
Pre- and Post-assessments to Measure Impact
Verified Certificate with a QR Verification Code

Fraud Risk Management in Social Insurance & Designing a Risk Framework