Claims Data Analytics, Fraud Detection and Prevention Workshop
Practical training designed around real insurance claims scenarios. Turn claims records into useful operational insights, uncover leakage indicators, and fortify loss reserves without programming required.
Insurance Claims Sandbox
Excel & Power BI live triage simulations on real loss portfolios.
About BIC Masterclass
BIC Masterclass is a leading consulting and training provider that focuses on addressing specific and key burning competency issues of the various sectors. We address these issues by providing tailor made solutions in the form of Master Classes (BIC Master Class), in-house Trainings and Conferences (BIC Conferences) delivered by expert trainers with hands-on expertise in the subject area at leading organizations.
We enable individuals to gain leading professional competencies that offer strategic edge over the respective industry demands. We help organizations and individuals achieve their goals by sharing knowledge, skills, abilities and insights gained by experienced BIC professionals and other industry experts.
Sectors served across regions of Ghana
Executives and department leads upskilled
Direct post-workshop operational application
Claims Generate Data. Your Team Needs to Know What the Data is Saying.
Every claim submitted, audited, and settled creates a digital footprint. Without analytics competency, vital operational signals slip unnoticed.
Claims Performance
Track settlement volume, claim frequency, loss severity, and identify operational bottlenecks in processing timelines.
Leakage Control
Uncover systemic overpayments, duplicate payments, missed subrogation opportunities, and off-tariff servicing vendor charges.
Fraud Awareness
Recognise anomaly patterns, suspicious loss clusters, repeated staging indicators, and provider billing irregularities before sign-off.
Better Decisions
Equip claims teams with defensible empirical evidence to support fair, compliant, timely, and policy-consistent determinations.
You Do Not Need to Be a Programmer
This masterclass focuses on practical spreadsheet formulas, pivot models, analytical inquiry techniques, and executive dashboards—translating claims data into actionable insights without writing code.
What You Will Learn
Ten operational pillars designed to translate raw underwriting and loss data into defensible decisions and cost-saving interventions.
Analyse Claims Data
Analyse claims data to identify trends, patterns, performance gaps and emerging risks across motor, health, life and property lines.
Clean & Organise Claims Data
Clean, validate and organise claims data for accurate analysis, stripping out corrupt registers, inconsistent policy records and format breaks.
Excel & Power BI Dashboards
Use Excel and Power BI to analyse claims and develop insightful dashboards that senior executives can query in real time.
Recognise Fraud Indicators
Recognise suspicious claims patterns, anomalies and potential fraud indicators before settlement authorizations are issued.
Detection & Risk Scoring
Apply rule-based detection, outlier analysis and basic risk scoring techniques to rank loss events by vulnerability indices.
Data-Driven Investigations
Use data-driven insights to prioritise and support claims investigations, optimizing the bandwidth of Special Investigation Units (SIU).
Assess Fraud Exposure
Identify vulnerabilities and assess potential fraud exposure across third-party repair networks, clinics, and claimant representations.
Proactive Prevention Controls
Recommend appropriate internal operational controls and proactive fraud prevention measures before losses materialize.
Claims Analytics Reporting
Develop claims analytics reports and communicate findings effectively to technical underwriting committees and governing boards.
Drive Operational Performance
Translate analytical insights into practical actions to improve claims processing velocity, lower loss adjustment expense (LAE) and control total claims costs.
Claims-Focused Course Modules
A comprehensive, rigorous two-day progression taking practitioners from raw data sanity through automated red-flag triage models. Click any module to preview key curriculum takeaways.
Fundamentals of Claims Data Analytics
Introduction to claims analytics; core insurance metrics: Loss Ratio, Claim Frequency, Loss Severity, Reserve Development & Triangles.
Claims Data Prep & Quality Management
Cleaning messy claims registers, structuring longitudinal claim tables, resolving duplicate records, addressing policyholder identity mismatches.
Advanced Analysis via Excel & Power BI
Pivot tables, cohort trend analysis, claim aging buckets, and high-impact visual dashboards designed specifically for insurance portfolios.
Insurance Fraud & Red Flag Indicators
Common schemes across motor staging, phantom healthcare billing, staged fire claims, inflated property loss assessments, and behavioral cues.
Advanced Fraud Detection & Risk Scoring
Unsupervised anomaly identification, cross-registry duplicate claimant matching, provider collusion rings, and rule-based risk ranking matrices.
Data-Driven Claims Investigation & SIU
Prioritizing high-risk claims for Special Investigation Units (SIU), structuring evidentiary documentation, forensic chain of custody, audit trails.
Fraud Prevention & Claims Controls
Designing resilient internal underwriting-to-claims controls, enterprise fraud risk assessment matrices, and governance compliance protocols.
Analytics Reporting & Executive Dashboards
Operational and Board-level reporting frameworks, KPI dashboards, and establishing a 90-day institutional action roadmap for claims teams.
What You Will Be Able to Do
Return to your office on Monday morning with an immediate upgrade in technical precision, defensibility, and analytical execution.
Analyse Data
Transform thousands of messy claim rows into clear trend-lines, pinpointing portfolio health, seasonal spikes, and under-reserved exposure in minutes.
Spot Inefficiencies
Identify exact operational bottlenecks in claims registration, documentation delays, and third-party adjuster approvals that inflate claims cycle costs.
Improve Decisions
Replace subjective gut-feel with quantified risk scoring, allowing adjusters to approve legitimate payouts faster while stopping questionable claims cold.
Detect Fraud
Spot collusive repair vendor charges, duplicate invoice submissions, staged loss patterns, and claimant identity anomalies before checks are drawn.
Better Reporting
Build boardroom-ready visual executive dashboards that communicate loss ratios, reserve movements, and fraud containment ROI clearly to Managing Directors.
Control Costs
Plug systemic claims leakage, enforce service vendor tariff compliance, accelerate salvage recoveries, and optimize claims operations spend.
Who Should Attend
Engineered specifically for professionals responsible for loss ratios, operational reserve accuracy, and investigative integrity.
Claims Officers & Adjusters
Front-line claims adjusters seeking to supercharge day-to-day triage velocity, evaluate loss documentation with statistical rigor, and eliminate subjective processing delays.
Claims Supervisors & Managers
Heads of claims departments needing automated visibility into department cycle times, team workload distribution, reserve movements, and portfolio loss trends.
Fraud & Risk Officers
Special Investigation Units (SIU) and risk governance teams focused on designing empirical red-flag algorithms, provider collusion analysis, and early-warning tripwires.
Audit & QA Teams
Internal audit leads and quality assurance inspectors looking to run automated longitudinal audits across thousands of settled claim folders without sampling biases.
Secure Your Organization's Seats
Enroll your team to build defensible claims analytics capacity. Cohort registration includes full course manual, ready-to-deploy spreadsheet templates, lunch, and executive certification.
Download Comprehensive Workshop Brochure
Get the full 14-page syllabus including breakdown of datasets, sample case exercises, trainer CVs, and hotel logistics.