Postgraduate DiplomaInsurance, Risk & Actuarial Data Applications open

Postgraduate Diploma in Fraud Detection Techniques in Claims

Online 800-hour Postgraduate Diploma in Fraud Detection Techniques in Claims. 8 modules covering Regulation (EU) 2024/1689 (Artificial Intelligence Act), Regulation (EU) 2016/679 (GDPR) and Python (scikit-learn, PyOD). Assigned tutor and open enrolment.

Duration800 h
ModeOnline
AwardSEIUM Institute diploma

Postgraduate Diploma in Fraud Detection Techniques in Claims — studying from New Zealand

New Zealand's insurance and financial services sector is concentrated in Auckland and Wellington, with a strong focus on general insurance, life insurance and risk management. Natural hazard risk, particularly from earthquakes, is a major consideration, and the Earthquake Commission provides residential natural disaster cover. Actuarial and risk data professionals work for insurers, reinsurers, regulators and consultancies, with oversight from the Reserve Bank of New Zealand and the Financial Markets Authority.

Fees for New Zealand: NZ$1,770 (New Zealand dollar), with instalments and employer sponsorship available.

Relevant bodies in New Zealand

  • Reserve Bank of New Zealand (Te Pūtea Matua)
  • Institute of Actuaries of New Zealand
  • Financial Markets Authority (Te Mana Tātai Hokohoko)

Typical roles

  • Actuarial Analyst
  • Risk Analyst
  • Insurance Data Analyst
  • Catastrophe Risk Modeller

Questions from New Zealand

Which New Zealand bodies recognise actuarial and risk qualifications?

The Actuarial Society of New Zealand and the New Zealand Institute of Actuaries work alongside international bodies such as the Institute and Faculty of Actuaries. Membership and professional credentials in these fields are set by those bodies, not by private providers. SEIUM's qualifications are private and not accredited by any national body, so their standing depends on how your employer or the relevant body assesses them.

Do insurers and financial firms in New Zealand hire people with data and risk skills?

New Zealand's insurance, banking and government sectors do employ people in risk, pricing and data analysis, and the Reserve Bank and insurers both draw on these skills. Hiring usually depends on demonstrated technical ability and professional credentials. A SEIUM qualification can support your application, but whether it is valued is up to each employer.

How is the programme delivered and paid for?

The programme is 100% online and taught in English, so no student visa is needed to study from New Zealand. You are assigned a technical tutor and complete a final project. Fees are payable in instalments, and employer sponsorship is possible. Time commitment varies by programme, from 300 hours for specialist courses to 1,900 hours for master's programmes.

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Learning outcomes

What you will be able to do

01

Identify fraud risk points in the claims handling cycle.

02

Prepare claims data for anti-fraud models, including handling class imbalance.

03

Train supervised fraud detection models.

04

Apply unsupervised techniques to uncover anomalous patterns.

05

Analyse relationship networks to detect organised fraud.

06

Extract fraud signals from text, images and documents.

07

Deploy and govern anti-fraud models with criteria for explainability and data protection.

Profile

Who it's for

  • Anti-fraud data scientist looking to specialise in Fraud Detection Techniques in Claims.
  • Claims fraud analyst looking to specialise in Fraud Detection Techniques in Claims.
  • Anti-fraud model manager looking to specialise in Fraud Detection Techniques in Claims.
  • Insurance data engineer looking to specialise in Fraud Detection Techniques in Claims.
  • Fraud network investigator looking to specialise in Fraud Detection Techniques in Claims.
  • AI governance manager looking to specialise in Fraud Detection Techniques in Claims.
  • Engineering or science graduates seeking to enter insurance companies.
Standards & tools

What you'll work with

  • Regulation (EU) 2024/1689 (Artificial Intelligence Act)
  • Regulation (EU) 2016/679 (GDPR)
  • Law 20/2015 (LOSSEAR), shared files for fraud prevention
  • Organic Law 3/2018 (LOPDGDD)
  • ISO/IEC 42001 (artificial intelligence management systems)
  • ISO/IEC 27001 (information security)
  • ISO 31000 (risk management)
Syllabus

8 modules · 800 h

  1. 1.1Claims lifecycle and risk points
  2. 1.2Fraud patterns in motor, home and health
  3. 1.3Fraud metrics and their quantification
  4. 1.4Labels: confirmed and suspected fraud
  5. 1.5Data available at opening and processing
  6. 1.6Cost of investigating versus paying
  7. 1.7Legal framework for processing anti-fraud data
  8. 1.8Organisation of detection within the insurer
  9. 1.9State of the art in anti-fraud analytics
  10. 1.10Case study: analysis of a claims portfolio
  1. 2.1Integration of policies, claims and payments
  2. 2.2Data quality and missing values
  3. 2.3Feature engineering for behavioural variables
  4. 2.4Temporal and sequence variables
  5. 2.5Extreme class imbalance
  6. 2.6Sampling, SMOTE and weightings
  7. 2.7Information leakage during training
  8. 2.8Time-based validation partitions
  9. 2.9Anonymisation and pseudonymisation
  10. 2.10Laboratory: motor fraud training dataset
  1. 3.1Logistic regression and scorecards
  2. 3.2Trees and Random Forest
  3. 3.3Gradient boosting with XGBoost and LightGBM
  4. 3.4Probability calibration
  5. 3.5Metrics: AUC, precision at k and PR curve
  6. 3.6Thresholds according to investigative capacity
  7. 3.7Explainability with SHAP
  8. 3.8Model stability over time
  9. 3.9Comparison with expert rules
  10. 3.10Practice: fraud scoring model with XGBoost
  1. 4.1Anomaly and outlier detection
  2. 4.2Isolation Forest and LOF
  3. 4.3Autoencoders for unusual patterns
  4. 4.4Clustering of suppliers and garages
  5. 4.5Benford's Law applied to amounts
  6. 4.6Duplicate and similarity analysis
  7. 4.7Semi-supervised learning
  8. 4.8Validation without labels
  9. 4.9Combination with supervised models
  10. 4.10Laboratory: anomalies in repair invoices
  1. 5.1Graphs of people, vehicles and addresses
  2. 5.2Entity resolution
  3. 5.3Centrality metrics
  4. 5.4Community detection
  5. 5.5Graph databases with Neo4j
  6. 5.6Graph neural networks applied to fraud
  7. 5.7Visualisation of suspicious networks
  8. 5.8Organised fraud and networks of collaborators
  9. 5.9Integration with individual scoring
  10. 5.10Practice: detection of a network of linked claims
  1. 6.1Natural language processing in statements
  2. 6.2Language models for summarising case files
  3. 6.3Detection of inconsistencies in accounts
  4. 6.4Forensic analysis of images and metadata
  5. 6.5Detection of manipulated documents
  6. 6.6Reused images and reverse search
  7. 6.7Voice and call analysis with ethical limitations
  8. 6.8Multimodal integration of signals
  9. 6.9Risks of bias and false positives
  10. 6.10Workshop: text classifier for friendly settlements
  1. 7.1Integration into the claims workflow
  2. 7.2Real time versus batch processing
  3. 7.3Alert management and prioritisation
  4. 7.4Feedback from investigators
  5. 7.5Monitoring and retraining
  6. 7.6European AI Regulation and human oversight
  7. 7.7GDPR and automated decisions
  8. 7.8Fairness and non-discrimination
  9. 7.9Measuring return and savings
  10. 7.10Case study: putting an anti-fraud model into production
  1. 8.1Definition of the scope and the problem
  2. 8.2Preparation of the dataset
  3. 8.3Exploratory analysis
  4. 8.4Supervised and unsupervised modelling
  5. 8.5Network analysis
  6. 8.6Selection of operational thresholds
  7. 8.7Economic evaluation
  8. 8.8Deployment and governance plan
  9. 8.9Report and presentation
  10. 8.10Final review with the tutor
Methodology, software & labs

How you'll learn

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

Each module combines theory, guided reading of the original standard and applied exercises. The working software is Python (scikit-learn, PyOD), Neo4j, FRISS, SAS Fraud Management, spaCy, in free, academic or evaluation versions. Trials are studied using real procedures for fraud scoring models with imbalanced data, anomaly detection in claims, and graph analysis of relationships between those involved. Assessment is continuous across each module plus the final integrative project.

Hands-on practical workwith industry-standard software, simulation, real case studies and guided practical exercises.
Evidence-oriented final project:safety case, test plan, compliance dossier and operational limits.
Industry mentoring:faculty with professional experience in the field and in real industry projects.
Flexible format(100% online), international cohorts and support from SEIUM Career Services.
Ethics and safety:a safety-by-design approach, cybersecurity and regulatory compliance as 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 scope and the problem

Identify fraud risk points in the claims handling cycle.

Preparation of the dataset

Prepare claims data for anti-fraud models, including handling class imbalance.

Exploratory analysis

Train supervised fraud detection models.

Supervised and unsupervised modelling

Apply unsupervised techniques to uncover anomalous patterns.

Network analysis

Analyse relationship networks to detect organised fraud.

Career opportunities

Where this takes you

Anti-fraud data scientistClaims fraud analystAnti-fraud model managerInsurance data engineerFraud network investigatorAI governance manager
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 English to follow technical regulatory reading.

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.

You will work with Python (scikit-learn, PyOD), Neo4j, FRISS, SAS Fraud Management and spaCy. Free, academic or evaluation versions are used, and the tutor indicates the free alternative where one exists.

An own diploma from SEIUM upon passing the continuous assessment and the integrative project. It is in-house training, not an official qualification from the Ministry.

Yes. Modules passed in a course or postgraduate diploma in the same area are credited towards the advanced programme. Check the credit transfer policy when you enrol.

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