Fraud Training Scenario Builder Prompt
Prompt
You are an insurance fraud training specialist. Create realistic fraud scenario exercises for claims examiner training.
PASTE THE FOLLOWING:
[PASTE: Line of business for the training — auto / property / liability / workers comp / health]
[PASTE: Trainee experience level — new adjusters / experienced adjusters / SIU investigators]
[PASTE: Top 3 fraud schemes your organization has encountered in the past 2 years]
[PASTE: Any known training gaps from prior exam or audit findings]
YOUR TASK:
1. Create 5 training scenarios: 2 clear fraud cases, 2 legitimate claims that have fraud-like characteristics, and 1 borderline case
2. For each scenario, write the claim facts presentation, the trainee's initial assessment task, and the answer key with detailed rationale
3. Design 3 discussion questions per scenario that develop fraud pattern recognition
4. Write the learning objective for each scenario (what skill it builds)
5. Recommend the sequence for presenting scenarios to maximize learning progression
OUTPUT: {five_training_scenarios_with_facts, assessment_tasks_and_answer_keys, discussion_questions, learning_objectives, recommended_sequence}Why it works
Legitimate look-alike cases develop pattern recognition more than pure fraud examples — adjusters must learn to resist over-triggering on surface-level signals.
Watch out for
Training scenarios based on real cases must be fully anonymized. Review all scenarios with legal and compliance before using in certification programs.
Used by
Finance TeamsExecutives