Postgraduate DiplomaInsurance, Risk & Actuarial Data Applications open

Postgraduate Diploma in Early Fraud Detection in Insurance Claims

800-hour online Postgraduate Diploma in Early Fraud Detection in Insurance Claims. 8 modules covering Law 20/2015 (LOSSEAR, common anti-fraud files), Regulation (EU) 2016/679 (GDPR) and Python (scikit-learn, XGBoost). Assigned tutor and enrolment open.

Duration800 h
ModeOnline
AwardSEIUM Institute diploma

Postgraduate Diploma in Early Fraud Detection in Insurance Claims — studying from Malta

Insurance is one of Malta's established financial sectors, with a regulatory framework that has attracted captive insurers, reinsurers and specialist underwriters. This creates demand for professionals who can model risk, analyse claims data and support actuarial functions. Engineers with statistical skills are valued in pricing, reserving and risk management. Employers include licensed insurers, brokers, consultancies and the regulator itself, where quantitative and technical expertise is increasingly important.

Fees for Malta: €1,090 (Euro), with instalments and employer sponsorship available.

Relevant bodies in Malta

  • Malta Financial Services Authority (MFSA)
  • Malta Insurance Association
  • Institute of Financial Services Malta
  • Actuarial Society of Malta

Typical roles

  • Actuarial Analyst
  • Risk Analyst
  • Insurance Data Scientist
  • Reinsurance Analyst

Questions from Malta

Which professional bodies in Malta relate to insurance, risk and actuarial work, and does SEIUM's qualification fit?

SEIUM Institute's qualifications are private qualifications, not official Maltese state degrees, and they are not accredited by any national body. In Malta, insurance and financial services are supervised by the Malta Financial Services Authority, and professional actuarial qualifications are set by international bodies that Maltese firms commonly follow. Whether SEIUM's training is recognised is for employers or the relevant body to decide.

What roles in Malta might this training support in insurance or risk management?

Malta has a significant insurance, reinsurance and financial services sector, and firms there employ people in risk analysis, data and modelling roles. Whether a private engineering-focused qualification counts for a given role depends on the employer's requirements and the qualifications they already expect. Reviewing current job descriptions in Malta and asking employers directly will show how your training would be viewed.

How much time does this need each week, and what language level is required?

Master's programmes total 1,900 hours, postgraduate diplomas 800 hours and specialist courses 300 hours, delivered fully online. Spread over the programme length, this suits people working full-time if they set a steady weekly schedule. Teaching is in English, so you should be comfortable reading and writing technical English. Fees can be paid in instalments, and employer sponsorship is possible.

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Learning outcomes

What you will be able to do

01

Characterise the typologies of claims fraud.

02

Design detection systems based on expert rules.

03

Train supervised fraud detection models.

04

Apply unsupervised techniques to uncover anomalous patterns.

05

Analyse relationship networks to detect organised fraud.

06

Implement early detection at the point of claim opening.

07

Govern anti-fraud models in line with data and AI regulations.

Profile

Who it's for

  • Insurance fraud analyst who wants to specialise in Early Fraud Detection in Insurance Claims.
  • Anti-fraud data scientist who wants to specialise in Early Fraud Detection in Insurance Claims.
  • Claims investigator who wants to specialise in Early Fraud Detection in Insurance Claims.
  • Head of the anti-fraud unit who wants to specialise in Early Fraud Detection in Insurance Claims.
  • Specialist claims handler who wants to specialise in Early Fraud Detection in Insurance Claims.
  • Compliance consultant who wants to specialise in Early Fraud Detection in Insurance Claims.
  • Graduates in engineering or science who wish to enter insurance companies.
Standards & tools

What you'll work with

  • Law 20/2015 (LOSSEAR, common anti-fraud files)
  • Regulation (EU) 2016/679 (GDPR)
  • Organic Law 3/2018 (personal data protection and guarantee of digital rights)
  • Regulation (EU) 2024/1689 (Artificial Intelligence Act)
  • Law 10/2010 on the prevention of money laundering
  • ISO 37001 (anti-bribery management systems)
  • ISO/IEC 42001 (AI management systems)
Syllabus

8 modules · 800 h

  1. 1.1Typologies of claims fraud
  2. 1.2Opportunistic fraud versus organised fraud
  3. 1.3Estimates of the scale of fraud
  4. 1.4Warning indicators by line of business
  5. 1.5Article 16 of the Ley de Contrato de Seguro
  6. 1.6Fraud investigation units
  7. 1.7Fraud in motor, home and health insurance
  8. 1.8Cost of fraud in the premium
  9. 1.9Ethics and presumption of innocence
  10. 1.10Case study: fraud patterns in motor claims
  1. 2.1Catalogue of alert indicators
  2. 2.2Business rules engines
  3. 2.3Additive scoring by indicator
  4. 2.4Internal lists of suspicious entities
  5. 2.5TIREA sector files
  6. 2.6Periodic review of effectiveness
  7. 2.7Managing false positives
  8. 2.8Integration at claim opening
  9. 2.9Auditing and traceability of rules
  10. 2.10Practical exercise: rules engine on historical claims
  1. 3.1Building labels from investigations
  2. 3.2Extreme class imbalance
  3. 3.3Logistic regression as a baseline model
  4. 3.4Gradient boosting with claim variables
  5. 3.5Precision, recall and the PR curve
  6. 3.6Expected cost of investigation
  7. 3.7Threshold selection by capacity
  8. 3.8Interpretability with SHAP values
  9. 3.9Recalibration against new schemes
  10. 3.10Laboratory: fraud model with imbalanced data
  1. 4.1Anomaly detection in claims
  2. 4.2Isolation Forest and LOF
  3. 4.3Autoencoders for atypical patterns
  4. 4.4Clustering of similar claims
  5. 4.5Benford’s Law applied to amounts
  6. 4.6Anomalies in time series of declarations
  7. 4.7Combination with supervised models
  8. 4.8Validation with investigation teams
  9. 4.9Managing unlabelled alerts
  10. 4.10Practical exercise: anomalies in garage invoices
  1. 5.1Graphs of policyholders, vehicles and suppliers
  2. 5.2Entity resolution and duplicates
  3. 5.3Community detection with Louvain
  4. 5.4Centrality and betweenness measures
  5. 5.5Neo4j graph databases
  6. 5.6Identification of organised rings
  7. 5.7Visualisation for investigators
  8. 5.8Graph neural networks
  9. 5.9Use of analysis in legal proceedings
  10. 5.10Laboratory: ring detection in Neo4j
  1. 6.1Scoring at first notification
  2. 6.2Telematic collision signals
  3. 6.3Automated analysis of documentation
  4. 6.4Detection of manipulated images
  5. 6.5Analysis of claim statement texts
  6. 6.6Real-time scoring
  7. 6.7Prioritisation of cases for investigation
  8. 6.8Investigation and resolution workflow
  9. 6.9Feedback of results to the model
  10. 6.10Case study: early alerts in home claims
  1. 7.1Data processing under legitimate interest
  2. 7.2Common files and data protection
  3. 7.3AI regulation in the insurance sector
  4. 7.4Risk of indirect discrimination
  5. 7.5Auditing anti-fraud models
  6. 7.6Chain of custody of evidence
  7. 7.7Sector collaboration and ICEA
  8. 7.8Anti-fraud effectiveness indicators
  9. 7.9Training of claims handlers
  10. 7.10Workshop: corporate fraud detection policy
  1. 8.1Definition of the use case
  2. 8.2Data preparation and labelling
  3. 8.3Design of the rules system
  4. 8.4Training of the supervised model
  5. 8.5Entity network analysis
  6. 8.6Integration into the claims workflow
  7. 8.7Assessment of expected savings
  8. 8.8Regulatory compliance plan
  9. 8.9Report and presentation
  10. 8.10Final review with the tutor
Methodology, software & labs

How you'll learn

100% online training on the SEIUM campus, with downloadable material, recorded classes and an assigned technical tutor. No fixed timetables: students progress at their own pace within the intake, which makes it possible to combine the programme with work.

Each module combines theory, guided reading of the original standard and applied exercises. The working software is Python (scikit-learn, XGBoost), Neo4j, SAS Fraud Management, Shift Technology, R, in free, academic or evaluation versions. Practical work is based on real procedures for fraud scoring models at claim opening, analysis of networks of those involved, and review of alerts with investigators. Assessment is continuous by module, plus the final integrative project.

Accreditable laboratories(EN ISO/IEC 17025) with rotor test rig, EMC/Lightning pre-compliance, HIL/SIL, vibration/acoustics.
Evidence-oriented thesis:safety case, test plan, compliance dossier and operational limits.
Industry mentoring:lecturers with experience in training, , eVTOL/UAM and flight test.
Flexible format(hybrid/online), international cohorts and support from SEIUM Career Services.
Ethics and safety:safety-by-design approach, cyber-OT, DIH and compliance as core pillars.
Capstone project

Build it end to end

Your final project follows the real engineering workflow, step by step, reviewed by your tutor.

Definition of the use case

Characterise the typologies of claims fraud.

Data preparation and labelling

Design detection systems based on expert rules.

Design of the rules system

Train supervised fraud detection models.

Training of the supervised model

Apply unsupervised techniques to uncover anomalous patterns.

Entity network analysis

Analyse relationship networks to detect organised fraud.

Career opportunities

Where this takes you

Insurance fraud analystAnti-fraud data scientistClaims investigatorHead of the anti-fraud unitSpecialist claims handlerCompliance consultant
Admissions & scholarships

Requirements

  • Prior technical training or professional experience in the sector. No university degree is required.
  • Internet connection and a computer capable of running the programme’s software.
  • Sufficient Spanish to follow technical regulatory texts.

Ready to start?

Send your application today. Our admissions team replies within 72 hours with your study plan and funding options.

FAQ

Frequently asked questions

The programme comprises 800 hours in total, spread over 6 to 8 months. That is an average of 10 to 15 hours per week, compatible with a full-time job.

The programme uses Python (scikit-learn, XGBoost), Neo4j, SAS Fraud Management, Shift Technology and R. Free, academic or evaluation versions are used, and the tutor indicates the free alternative where one exists.

An SEIUM own diploma upon passing the continuous assessment and the integrative project. This is private training, not an official qualification from the Ministry.

Yes. Modules passed in a course or diploma in the same area can be credited towards the advanced programme. Please consult the credit recognition policy when you enrol.

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