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1
Fraud Risk Management Framework
Insurance Industry
Riskpro, India
2
About Riskpro
3
Background - Who is Riskpro… Why us?
ABOUT US
 Riskpro is an organisation of member firms
around India devoted to client service
excellence. Member firms offer wide range
of services in the field of risk management.
 Currently it has offices in three major cities
Mumbai, Delhi and Bangalore and alliances
in other cities.
 Managed by experienced professionals with
experiences spanning various industries.
MISSION
 Provide integrated risk management
consulting services to mid-large sized
corporate /financial institutions in India
 Be the preferred service provider for
complete Governance, Risk and Compliance
(GRC) solutions.
VALUE PROPOSITION
 You get quality advisory, normally delivered
by large consulting firms, at fee levels
charged by independent & small firms
 High quality deliverables
 Multi-skilled & multi-disciplined organisation.
 Timely completion of any task
 Affordable alternative to large firms
DIFFERENTIATORS
 Risk Management is our main focus
 Over 200 years of cumulative experience
 Hybrid Delivery model
 Ability to take on large and complex projects
due to delivery capabilities
 We Hold hands, not shake hands.
4
Riskpro’s Network Presence
New Delhi
Mumbai
Bangalore
Ahmedabad
Pune
Agra
Salem
Kolkata
Hyderabad
Chennai
Jaipur
5
Risk Management Advisory Services
Training Recruitment
Basel II/III Advisory
 Market Risk
 Credit Risk
 Operational Risk
 ICAAP
Corporate Risks
 Enterprise Risk Assessment
 Fraud Risk
 Risk based Internal Audit
 Operations Risk
 Forensic services
Information Security
 IS Audit
 Information Security
 IT Assurance
 IT Governance
Operational Risk
 Process reviews
 Policy/ Process Review
 Process Improvement
 Compliance Risk
Governance
 Corporate Governance
 Business Strategic risk
 Fraud Risk
 Forensic Accounting
Other Risks
 Business/Strategic Risk
 Reputation Risk
 Outsourcing Risk
 Contractual Risk
 Banking – E Learning
 Corporate Training
 Regular Risk Management Training
 Online Training material
 Workshops / Events
 Virtual Risk Managers
 Full Time Risk Professionals
 Part time Risk Professionals
 Risk Managers on call – free
SERVICES
6
Fraud – Why companies should be concerned?
 Fraud is increasingly becoming a significant issue for Corporate
India and insurance companies are also affected. In the E&Y study
“India Fraud Indicator 2012” 1, Insurance companies were cited as
the worst hit financial services companies after banks. Another
2012 study reported that Indian Insurers lost over Rs 30,000 crore
due to frauds in 20112 and that collusion between the employees of
insurers and private persons, document falsification and
manipulation in citing cause of as some of the more common
reasons behind these frauds.
 In another E&Y survey in 2010-113, 40% of respondents reported
that fraud incidents are on the rise and that claim/surrender and
premium related frauds accounted for almost half of fraud risk
exposure. The survey also noted with concern that nearly 40% of
insurers did not have a dedicated anti-fraud departments.
1 “India Fraud Indicator 2012” A study by Ernst & Young India
2 “Insurers lost over Rs 30k crore due to frauds in 2011, says study” Economic Times Mar 4, 2012
3 “Fraud in insurance on rise” Survey 2010–11 by Ernst & Young India
“Mumbai: Four held for duping widow of
husband's life insurance money” Mid-Day Jan 24
2012
“Four sentenced to jail terms for clearing bogus
insurance claim” Zee News Dec14th 2012
7
Regulator’s View
 IRDA in January 2013 came out with guidelines on
Insurance Fraud Monitoring Framework.
 The guidelines requires insurance companies & reinsurers
to come up with policy, process and procedures to assess,
identify, monitor, and mitigate fraud risks and investigate &
close fraud reports.
 This covers all policyholder, intermediaries & internal
frauds.
 The compliance reports are due to be filed by 30th June
2013. The stipulations on fraud detection, classification,
monitoring and reporting is effective from Financial Year
2013-14
8
Avenues for Frauds
Policyholder
Intermediaries
Employees
Fraud
Consequence
•Monetary Loss
•Reputation
•Lost business
•Regulatory
actions
9
Fraud Risk Management Framework
Fraud Risk
Assessment
Anti-Fraud
Procedures
Fraud
Investigations
Anti-Fraud
Culture
Anti-Fraud
Governance
Respond
10
Anti Fraud Program
10
Governance
•Risk Management Committee
•Fraud Policy
•Monitoring Reports
•Due Diligence on
•Staff & Intermediaries
Fraud Response
• Internal & external
reporting
• Fraud Investigation
Manual
• Coordination with
authorities
Fraud Assessment
• Identifying potential fraud
in products & processes
• Control Gap analysis
• Antifraud manual &
procedures
• Fraud monitoring
Fraud Risk Management
Program
Fraud Awareness
• Staff training,
induction raining &
refresher
• Fraud manual &
SOPs
• Reporting process
• Whistle-blower policy
11
Key Stipulations from IRDA’s Circular
Governance
 Risk Management Committee
 Board Approved Fraud Policy
 Responsibilities & accountabilities for fraud prevention, detection & response
 Due diligence of staff and intermediaries for fraud risk
 Independent review of anti-fraud systems & procedures
 Management, Board & Compliance reports
Fraud Risk Assessment
 Identification of potential areas & departments for fraud threat
 Review of processes & products for fraud vulnerabilities
 Gap assessment between desired controls & actual controls
 Department-wise Anti-fraud procedures for prevention, identification and
mitigation of frauds
 Red flags for fraud monitoring
12
Fraud Response and Awareness
Fraud Response
 Internal & external fraud reporting
 Fraud investigation manual
 Legal process for any crimes under CRPC
 Coordination with law enforcement
Fraud Awareness
 Staff training, induction raining & refresher
 Fraud manuals & SOPs
 Clear process of internal & external fraud reporting
 Whistle blower policy & procedure
 Awareness to intermediaries & policyholders
13
RiskPro Approach
Fraud Risk
Identification
Fraud
Prevention/
Detection
Fraud
Reporting
• Identify fraud scenarios
& factors for products
and processes
• Assess likelihood of
occurrence and
resultant impact on the
organization
• Fraud policy with clear
accountabilities &
fraud response
• Fraud Manual & SOPs
• Whistle-blower policy
• Anti Fraud Manual
• Continuous monitoring
of fraud via indicators
• Awareness training
• Define reporting process
for internal & external
reporting
• Define coordinated
approach for
Investigation &
corrective actions
Other Policies such as HR Disciplinary policy
14
RiskPro’s Offering
Area Objective RiskPro Service Offering
Fraud Risk
Assessment
To identify the organization’s susceptibility
to specific types of fraud and the
likelihood and significance of those frauds
 Identify fraud scenarios &
factors for products and
processes
 Assess likelihood of
occurrence and resultant
impact on the organization
Control gap
Assessment
To assess effectiveness of anti-fraud
controls and implement or improve
control measures to appropriately manage
identified fraud risks
 Test existing controls
 Identify control gaps
 Recommend control
enhancements
Anti-Fraud
Procedures
To enable an organization to structure
Its operating policies & procedures so that
fraud will be detected if it occurs, and
ascertain that its anti-fraud policies and
procedures are well constructed, properly
communicated and followed
 Fraud policy with clear
accountabilities & fraud
response
 Fraud Manual & SOPs
 Whistle-blower policy
 Fraud Monitoring Reports
Fraud Awareness
Training
To enable an organization’s employees,
officers, directors and agents to identify
and respond appropriately to the signs of
fraud
 Awareness & specialised
anti-fraud training with
hands-on case studies to
staff and intermediaries
15
Riskpro Clients Our Clients
*Any trademarks or logos used throughout this presentation are the property of their respective owners
Banking/
Insurance
Corporate
MNC
Banking
Intl
Consulting
IT / Others
16
Team Experiences Our Experiences
Our team members have worked at world class Companies
*Any trademarks or logos used throughout this presentation are the property of their respective owners
17
RESUMES – Our team
 Co-Founder - Riskpro
 CA, CPA, MBA-Finance (USA), FRM (GARP)
 Over 10 years international experience – 6 years in Bahrain and 4 years USA
 15 years exp in risk management consulting and internal audits, Specialization in
Operational Risk, Basel II, Sox and Control design
 Worked for Ernst & Young (Bahrain), Arab Investment Company (Bahrain),
Navigant Consulting(USA), Kotak Mahindra Bank (India) and Credit Suisse(India)
 Sox Compliance project for Fannie Mae, USA ( $900+ Billion Mortgage Company)
ManojJain
 Co- Founder - Riskpro
 CA (India), MBA (Netherlands), CIA (USA)
 Over 15 years of extensive internal and external audit experience in India and
abroad.
 Worked with KPMG United Arab Emirates, PKF South Africa, Ernst and Young
Kuwait, Deloitte Netherlands and KPMG India.
 Worked with clients in a wide variety of industries and countries including trading,
retail and consumer goods, NGO, manufacturing and banking and finance. Major
clients include banks, investment companies, manufacturing organizations,
aviation etc.
RahulBhan
Credentials
18
RESUMES - Our team
 Co-Founder - Riskpro
 PGD (Electrical & Electronics & Computer Programming)
 30 years of experience in Information & Communications Technology (ICT) Solutions
for Retail, Garments, Manufacturing, Services Industries.
 Has created Companies, Divisions, Products, Brands, Teams & Markets.
 Consulting in Business, Technology, Marketing & Sales & Strategic Planning.
 Advisory, Training, Workshops & Implementation in Systems Thinking, Systems
Modeling & Balanced Scorecard
 Worked with TIFR, Mahindra, Ambience, Communico-Graphique & Ionidea Inc, USA,
CasperAbraham
Credentials
 Sr Vice President – Risk Management
 MBA, PDFM,NSE-NCFM, PMP, CSSGB,ISO 9001:2000 I.A,GARP-FBR, ITILV3,CPP-BPM
 Professional with 17 years of rich experience into diverse Consumer finance/ Lending
operations ,Risk Management,BPMS, Consumer Banking, NBFC, Management Consulting &
Housing finance in BFSI industry having successfully led key business strategic
engagements across multi-product environment in APAC, Australia and US regions.
 Worked with GE, ABN AMRO Bank, Citigroup, Accenture, Deutsche Postbank
 Highly skilled and expert Trainer in Risk areas across Credit, Fraud, Operational, Corporate
Risk management.
 Specializes in Fraud Control, AML/KYC Compliance ,QA ,ERM and Regulatory governance.
HemantSeigell
19
RESUMES - Our team
 Head - Insurance Risk Advisory services
 B.sc, Associate of Indian Institute of Insurance
 Licensed Category A Insurance surveyor
 26 years of experience in Insurance advisory services, Loss adjusting for large
corporates,Claims management.
 Has assessed more than 4500 high value insurance claims across various industry
sectors.
 Risk management inspection
 Valuations of fixed assets for insurance purpose.
R.Gupta
Credentials
 Head - Human Capital Management
 Chartered Accountant, Lead Assessor ISO 9000, Six Sigma Trained, Trained on Situational
Leadership, Trained on interviewing skills and Whole Message Model.
 Over two decades of international, multi-cultural experience in finance and human resources
viz. internal audit, accounting operations, accounting process review & re-designing, risk
management, business solutioning, six sigma projects, talent acquisition, talent retention,
organization design/redesigning, compensation and appraisal processing, employee and
customer satisfaction surveys, knowledge management and finance services.
 Worked with Citicorp/MGF, India Glycol, Delphi, American Express India, American Express
USA, Fidelity International and Macquarie Global Finance Services India.
NileshBhatia
20
RESUMES - Our team
 Head – Taxation Risk Advisory
 B.Com, FCA
 Senior Partner with 48 year old Delhi based Chartered Accountant firm, Mehrotra
and Mehrotra
 Over 19 years of experience in the field of Audit, Taxation, Company law matters.
 Major clients served are NTPC, BHEL, Bank of India, PNB, Airport Authority of
India etc.
RajeshJhalani
Credentials
President – Banking & Financial Services
 A senior researcher in Applied Mathematics leading to Ph.D after MSc (Mathematics),
CWA, CAIIB
 Combined experience of 25+ years in corporate banking, risk management,
international trade finance, development of risk rating models, project finance, credit
monitoring and NPA management
 Since 2006 conducting open / in-house training on the above domains to all Top
public/ new and old private sector banks, top MNC banks (India and abroad), leading
NBFCs and corporates in manufacturing and financial services space; Worked on IFC
(World Bank) funded projects for MSMEs in India and abroad
 Worked for Bank of Baroda and ICICI Bank – bestowed Top Performer Award
continuously two years during his tenure; widely travelled abroad for business
relations, seminars, offering training, investor meetings, NYSE listing and for
processes involving establishment of representative Office in USA
Sivaramakrishnan
21
Executive Vice President – Risk Management ( Banking & Financial Services)
 A hands-on banking professional {BSc (Mathematics), CAIIB} with considerable
domestic and international experience
 An aggregate experience of 24+ years across industry, mainly BFSI in several
functional areas including Retail and Commercial Banking, Corporate Lending, team
member of the Business Process Re-Engineering project (BPR); conceptualizing and
setting up shared services centres for centralized operations for the Bank in India.
 Management through ERM framework overseeing all key areas of the business
through various Operational Risk tools like KRI / RCSA matrices. Managing of major
project implementation of Basel II and Compliance risk framework
 Directing, reviewing and advising Board of Directors on various compliance issues and
representing the bank to the Central Bank regulatory offices.
 Worked for ANZ Grindlays Bank, Standard Chartered, Bahraini Saudi Bank and Dubai
Holdings ( subsidiary)
KashiBanerjeeRESUMES - Our team Credentials
Consultant – Information Security & IT Governance
 LLB, CA, CISA, CWA, CS, CFE and others
 Over 15 years of experience in the field of Audit, Taxation, Investigations.
 Specializing in the field of Systems Audit, Cybrex Audit, Computer Crime
Investigations, IS Forensics
 International Committee Member of Governmental and Regulatory Agencies
Board and Academic Relations Committee of ISACA, USA
AnjayAgarwal
22
Executive Vice President – Risk Management ( Banking & Financial Services)
 Professional Risk Manager with considerable domestic and international experience
 An aggregate experience of 30 + years across industry, mainly Banking in several functional areas
including Wholesale Credit Risk, Operational Risk, Trade Finance , Retail Banking and Islamic Financial
Services.
 Track record of setting up of excellence in the set-up, and management of credit and operational risk,
compliance and credit administration functions in retail, commercial , Islamic Banking and offshore banking
entities in the Middle East.
 Key strength includes Corporate Credits, Risk Management in IT, implementation of Risk Management
module in core banking Bank’s Policies, procedures, Country Risk. Played an active role in 3 core banking
software implementations
 Worked for a Private Sector Bank in India, ABN AMRO Bank, Bahrain, Bank Muscat Bahrain and BMI Bank
Bahrain as AGM Risk Management.
VijayanGovindarajanRESUMES - Our team Credentials
 Specialist Risk Consultant – ERP & IT Compliance
 SAP Certified, MBA (Finance), SAP Security trained (from SAP India), SAP GRC Access Controls trained
(from SAP India)
 Over 7 years of experience working in the area of ERP/IT Risk advisory, primarily focusing on SAP, for
‘Fortune 500’ clients in around 8 countries including US, UK, UAE, Hong Kong, etc
 Specializes in SAP Risk & Controls Advisory, SAP Business Process Controls Audit, SAP Security &
Segregation of Duties Control Audit, ERP Trainings,
 Strong Industry experiences ranging from Beverages, Insurance, Energy, FMCG, Pharmaceutical, Retail,
Telecommunication to IT Services
 Worked for risk advisory teams of reputed organizations like Ernst & Young, EXL Services
GouravLadha
23
RESUMES - Our team Credentials
 Vice President – IT Risk Advisory
 Over 14+ Years of Experience in Information Security and Risk Management & CISM
certified
 Headed the Global Information Security team of Daimler (Mercedes-Benz) Worldwide at
Bangalore for 9 years, previously worked at organization like Wipro, Bangalore Labs
 Multi-sector experience including Banking, Insurance, Finance, Energy, Manufacturing,
Retail, Hi-Tech & Telecom, and Automobile
 Well known Ethical hacker: Was featured in BusinessWorld Magazine in an article about
leading ethical hackers in India and published several articles in Print and Online Media
 Rich experience in Information Security Audits across Corporations, 3rd Party Suppliers, Joint
Ventures across several countries in the world including US, UK, China, Germany
AashishSrivastavaRavikiranBhandari
 Specialist Consultant – Legal Risk Advisory
 B.B.A. ,LL.B. (Hons.)
 About half a decade experience in legal services to client’s with respect to Contract
and Commercial Laws, Joint Ventures, Inbound & Outbound Investments, Private
Equity Investment Transactions, Real Estate & Infrastructure, Energy and General
Corporate.
 Have advised various social enterprises and start ups in setting up business in
India.
 Worked for the leading law firms of India such as FoxMandal Little.
24
RESUMES - Our team Credentials
PhanindraPrakash
 Vice President – Riskpro India
 FCA [India], ACMA [India], CFE [USA], CertIFRS [UK]
 Over 16 years of extensive consulting experience which includes financial & systems audit,
process transformation, implementation of internal controls, SOX compliance, fraud audits
& due diligence, US-India taxation
 Engaged in consulting roles as trusted advisor to finance, internal audit and information
technology executives of multiple Fortune 1000 companies with project sites in US,
Canada, Europe & Asia
 Worked with E&Y and Deloitte Consulting in USA
 Some of the major clients served internationally are GE Capital, UBS, McKesson, Eaton,
Imation, Albertsons,
 EVP and Head – Telecom Risk Advisory
 M.Tech (IIT Kharagpur),IES,Doctoral study, research and teaching in Linkoping
University/Sweden, Lead Auditor (BVQI).
 Over 30 years of International experience in networks and mobile Handsets from top global
companies /institutes like ISRO, Ericsson, Nokia, Nokia Siemens Networks based in its
head quarter locations in India, EU, USA.
 Expertise: Setting up capability, behaviour, culture in turning Risk, Quality, Innovation for
competitive advantage, customer delight and sustainability; key skill sets are Engagement,
Handholding, Coaching, Mentoring and lot of best practices, benchmarking/standards like
CMMI, TL9000, Six Sigma, ISO, SAS 70 etc.
AsokSit
25
RESUMES - Our team Credentials
SiddharthaGhosh
 Executive Vice President – Riskpro India
 CPA (USA), ACA, ACS, Grad CWA (India), MBA (USA), Associate ICPAS (Singapore)
 Over 25 years of extensive audit and industry experience which includes 19 years with
Rolls-Royce India Pvt Ltd at New Delhi and its associate and parent companies of Rolls-
Royce in UK, USA and Singapore in all aspects of Finance, Taxation, Audit, Banking, Legal,
Company Secretarial, Statutory compliances and due diligence, Internal Control, ESOP,
Budgets, Cashflows, Forecasts, MIS Reporting, HR, Expatriate & Office Administration,
Payroll, IT, Retirement Funds Administration, Shared Services, Project Accounts, etc.
 Worked with Price Waterhouse Coopers for 4 years with reputed MNCs, banks, Indian
corporate houses
 Worked with McNally Bharat Engineering Company Ltd for 4 years
PritiTawari
 Vice President – Riskpro India
 B. Com, ACA, Dip. IFRS
 Over 6 years of extensive audit and industry experience in all aspects of Finance, Taxation,
Audit, Legal, Company Secretarial, Statutory compliances and due diligence, Internal
Control, Budgets, Cash flows, Forecasts, MIS Reporting, HR, Expatriate & Office
Administration, Payroll, IT, Project Accounts, etc.
 Worked with Price Waterhouse Coopers for 3 years in audit & assurance for reputed
MNCs, Indian corporate houses.
 Engage in own practice since 2010 specialize in outsourcing of finance department in mid
size MNCs and consultation in Indirect Taxes and Management Reporting
26
RESUMES - Our team Credentials
ManojKumar
Senior Vice President
CAIIB
20 Years of hard core banking experience in India’s most reputed banks
across wide functional areas.
Worked with Central Bank of India, ICICI Bank, HDFC Bank, and Axis
Bank as Asst Vice President, Cluster Head, and Branch Head.
Areas of expertise are Financial Risk Management, NPA-Credit-Debt
Management, Asset Reconstruction, Project Finance, and others.
Accomplished several achievements in the functional areas of banking.
27
 Specialist Risk Consultant – Business Continuity
 Founder and 15-year Chairman of Survive, the first international user group for Business
Continuity professionals
 Founding director and first Fellow of the Business Continuity Institute
 Over 25 years international consulting expertise in Risk, Crisis, Emergency, Incident, and
Business Continuity and ICT Disaster Recovery Management
 Multi-sector experience including Banking, Insurance, Finance, Oil, Gas, Energy,
Manufacturing, Retail, Hi-Tech & Telecom
 Western Press Award for services to business, 1994; BCI/CIR nomination for
lifetime achievement in BC, 1999, London; inducted into BC Hall of Fame by CPM magazine,
2004, Washington DC.
AndrewHilesRESUMES - PARTNERSHIPS
 Specialist Risk Consultant – Enterprise Risk Management
 Highly skilled risk and insurance professional with 25 years of experience designing, developing and
implementing large, global corporate risk management programs for Fortune 500 firms.
 Principal Consultant and Founder - Excellence in Risk Management, LLC. (Texas, USA) Co-founder and
EVP, Professional Services, rPM3 Solutions, LLC (Maryland, USA).
 Past experiences include Head of Global Risk Management for USAA, PepsiCo/Tricon Global and American
National Red Cross
 Additional risk and insurance experience at Verizon Corp,. Marsh USA and Liberty Mutual Insurance Co.
 2004 Risk Manager of the Year – 2007 recipient of the Alexander Hamilton Award for “Excellence in ERM” (at
USAA) – former President, Risk and Insurance Management Society, Inc.
ChrisE.Mandel
28
Key Contacts
Corporate Mumbai Delhi Bangalore
Riskpro India Ventures (P)
Limited
info@riskpro.in
www.riskpro.in
F 186, Sarita Vihar
New Delhi 110076
Manoj Jain
Director
M- 98337 67114
manoj.jain@riskpro.in
Shriram Gokte
EVP - Risk Management
M- 98209 94063
shriram.gokte@riskpro.in
Sivaramakrishnan
President – Banking & FS
M- 98690 19311
smaran.iyer@riskpro.in
Rahul Bhan
Director
M- 99680 05042
rahul.bhan@riskpro.in
Hemant Seigell
SVP – Risk Management
M- 99536 97905
hemant.seigell@riskpro.in
Casper Abraham
Director
M- 98450 61870
casper.abraham@riskpro.in
Vijayan Govindarajan
EVP – Risk Management
M- 99166 63652
vijayan.govindarajan@riskpro.in
Ravikiran Bhandari VP – IT
Risk Advisory
M- 99001 69562
ravikiran.bhandari@riskpro.in
Ghaziabad / Noida Chennai Kolkata Gurgaon
Siddhartha Ghosh
EVP - Finance
M- 9810058072
Siddhartha.Ghosh@riskpro.in
R Gupta - Insurance Risk
M- 98101 07387
R. Muralidharan
EVP – Risk Management
M- 95660 77326
murali@riskpro.in
Kashi Banerjee
EVP – Risk Management
M- 98304 75375
kashi.banerjee@riskpro.in
Nilesh Bhatia
Head – Human Capital Mgt.
M- 98182 93434
nilesh.bhatia@riskpro.in
Asok Sit
EVP – Telecom Risk Advisory
M- 98105 03463
asok.sit@riskpro.in
Pune Salem Ahmedabad Hyderabad / Agra
M.L. Jain
Principal – Strategy Risk
M- 98220 11987
mljain@riskpro.in
Priti Tawari
M- 9011054085
Chandrasekeran
Recruitment franchisee
M – 94435 99132
Manoj Kumar
M – 98983 65320
Maulik Manakiwala
M – 98256 40046
Gourav Ladha
Phanindra Prakash (Hyderabad)
Member Firm
M- 95500 61616
Alok Kumar Agarwal (Agra)
Member Firm
M- 99971 65253

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Insurance fraud risk management service

  • 1. 1 Fraud Risk Management Framework Insurance Industry Riskpro, India
  • 3. 3 Background - Who is Riskpro… Why us? ABOUT US  Riskpro is an organisation of member firms around India devoted to client service excellence. Member firms offer wide range of services in the field of risk management.  Currently it has offices in three major cities Mumbai, Delhi and Bangalore and alliances in other cities.  Managed by experienced professionals with experiences spanning various industries. MISSION  Provide integrated risk management consulting services to mid-large sized corporate /financial institutions in India  Be the preferred service provider for complete Governance, Risk and Compliance (GRC) solutions. VALUE PROPOSITION  You get quality advisory, normally delivered by large consulting firms, at fee levels charged by independent & small firms  High quality deliverables  Multi-skilled & multi-disciplined organisation.  Timely completion of any task  Affordable alternative to large firms DIFFERENTIATORS  Risk Management is our main focus  Over 200 years of cumulative experience  Hybrid Delivery model  Ability to take on large and complex projects due to delivery capabilities  We Hold hands, not shake hands.
  • 4. 4 Riskpro’s Network Presence New Delhi Mumbai Bangalore Ahmedabad Pune Agra Salem Kolkata Hyderabad Chennai Jaipur
  • 5. 5 Risk Management Advisory Services Training Recruitment Basel II/III Advisory  Market Risk  Credit Risk  Operational Risk  ICAAP Corporate Risks  Enterprise Risk Assessment  Fraud Risk  Risk based Internal Audit  Operations Risk  Forensic services Information Security  IS Audit  Information Security  IT Assurance  IT Governance Operational Risk  Process reviews  Policy/ Process Review  Process Improvement  Compliance Risk Governance  Corporate Governance  Business Strategic risk  Fraud Risk  Forensic Accounting Other Risks  Business/Strategic Risk  Reputation Risk  Outsourcing Risk  Contractual Risk  Banking – E Learning  Corporate Training  Regular Risk Management Training  Online Training material  Workshops / Events  Virtual Risk Managers  Full Time Risk Professionals  Part time Risk Professionals  Risk Managers on call – free SERVICES
  • 6. 6 Fraud – Why companies should be concerned?  Fraud is increasingly becoming a significant issue for Corporate India and insurance companies are also affected. In the E&Y study “India Fraud Indicator 2012” 1, Insurance companies were cited as the worst hit financial services companies after banks. Another 2012 study reported that Indian Insurers lost over Rs 30,000 crore due to frauds in 20112 and that collusion between the employees of insurers and private persons, document falsification and manipulation in citing cause of as some of the more common reasons behind these frauds.  In another E&Y survey in 2010-113, 40% of respondents reported that fraud incidents are on the rise and that claim/surrender and premium related frauds accounted for almost half of fraud risk exposure. The survey also noted with concern that nearly 40% of insurers did not have a dedicated anti-fraud departments. 1 “India Fraud Indicator 2012” A study by Ernst & Young India 2 “Insurers lost over Rs 30k crore due to frauds in 2011, says study” Economic Times Mar 4, 2012 3 “Fraud in insurance on rise” Survey 2010–11 by Ernst & Young India “Mumbai: Four held for duping widow of husband's life insurance money” Mid-Day Jan 24 2012 “Four sentenced to jail terms for clearing bogus insurance claim” Zee News Dec14th 2012
  • 7. 7 Regulator’s View  IRDA in January 2013 came out with guidelines on Insurance Fraud Monitoring Framework.  The guidelines requires insurance companies & reinsurers to come up with policy, process and procedures to assess, identify, monitor, and mitigate fraud risks and investigate & close fraud reports.  This covers all policyholder, intermediaries & internal frauds.  The compliance reports are due to be filed by 30th June 2013. The stipulations on fraud detection, classification, monitoring and reporting is effective from Financial Year 2013-14
  • 8. 8 Avenues for Frauds Policyholder Intermediaries Employees Fraud Consequence •Monetary Loss •Reputation •Lost business •Regulatory actions
  • 9. 9 Fraud Risk Management Framework Fraud Risk Assessment Anti-Fraud Procedures Fraud Investigations Anti-Fraud Culture Anti-Fraud Governance Respond
  • 10. 10 Anti Fraud Program 10 Governance •Risk Management Committee •Fraud Policy •Monitoring Reports •Due Diligence on •Staff & Intermediaries Fraud Response • Internal & external reporting • Fraud Investigation Manual • Coordination with authorities Fraud Assessment • Identifying potential fraud in products & processes • Control Gap analysis • Antifraud manual & procedures • Fraud monitoring Fraud Risk Management Program Fraud Awareness • Staff training, induction raining & refresher • Fraud manual & SOPs • Reporting process • Whistle-blower policy
  • 11. 11 Key Stipulations from IRDA’s Circular Governance  Risk Management Committee  Board Approved Fraud Policy  Responsibilities & accountabilities for fraud prevention, detection & response  Due diligence of staff and intermediaries for fraud risk  Independent review of anti-fraud systems & procedures  Management, Board & Compliance reports Fraud Risk Assessment  Identification of potential areas & departments for fraud threat  Review of processes & products for fraud vulnerabilities  Gap assessment between desired controls & actual controls  Department-wise Anti-fraud procedures for prevention, identification and mitigation of frauds  Red flags for fraud monitoring
  • 12. 12 Fraud Response and Awareness Fraud Response  Internal & external fraud reporting  Fraud investigation manual  Legal process for any crimes under CRPC  Coordination with law enforcement Fraud Awareness  Staff training, induction raining & refresher  Fraud manuals & SOPs  Clear process of internal & external fraud reporting  Whistle blower policy & procedure  Awareness to intermediaries & policyholders
  • 13. 13 RiskPro Approach Fraud Risk Identification Fraud Prevention/ Detection Fraud Reporting • Identify fraud scenarios & factors for products and processes • Assess likelihood of occurrence and resultant impact on the organization • Fraud policy with clear accountabilities & fraud response • Fraud Manual & SOPs • Whistle-blower policy • Anti Fraud Manual • Continuous monitoring of fraud via indicators • Awareness training • Define reporting process for internal & external reporting • Define coordinated approach for Investigation & corrective actions Other Policies such as HR Disciplinary policy
  • 14. 14 RiskPro’s Offering Area Objective RiskPro Service Offering Fraud Risk Assessment To identify the organization’s susceptibility to specific types of fraud and the likelihood and significance of those frauds  Identify fraud scenarios & factors for products and processes  Assess likelihood of occurrence and resultant impact on the organization Control gap Assessment To assess effectiveness of anti-fraud controls and implement or improve control measures to appropriately manage identified fraud risks  Test existing controls  Identify control gaps  Recommend control enhancements Anti-Fraud Procedures To enable an organization to structure Its operating policies & procedures so that fraud will be detected if it occurs, and ascertain that its anti-fraud policies and procedures are well constructed, properly communicated and followed  Fraud policy with clear accountabilities & fraud response  Fraud Manual & SOPs  Whistle-blower policy  Fraud Monitoring Reports Fraud Awareness Training To enable an organization’s employees, officers, directors and agents to identify and respond appropriately to the signs of fraud  Awareness & specialised anti-fraud training with hands-on case studies to staff and intermediaries
  • 15. 15 Riskpro Clients Our Clients *Any trademarks or logos used throughout this presentation are the property of their respective owners Banking/ Insurance Corporate MNC Banking Intl Consulting IT / Others
  • 16. 16 Team Experiences Our Experiences Our team members have worked at world class Companies *Any trademarks or logos used throughout this presentation are the property of their respective owners
  • 17. 17 RESUMES – Our team  Co-Founder - Riskpro  CA, CPA, MBA-Finance (USA), FRM (GARP)  Over 10 years international experience – 6 years in Bahrain and 4 years USA  15 years exp in risk management consulting and internal audits, Specialization in Operational Risk, Basel II, Sox and Control design  Worked for Ernst & Young (Bahrain), Arab Investment Company (Bahrain), Navigant Consulting(USA), Kotak Mahindra Bank (India) and Credit Suisse(India)  Sox Compliance project for Fannie Mae, USA ( $900+ Billion Mortgage Company) ManojJain  Co- Founder - Riskpro  CA (India), MBA (Netherlands), CIA (USA)  Over 15 years of extensive internal and external audit experience in India and abroad.  Worked with KPMG United Arab Emirates, PKF South Africa, Ernst and Young Kuwait, Deloitte Netherlands and KPMG India.  Worked with clients in a wide variety of industries and countries including trading, retail and consumer goods, NGO, manufacturing and banking and finance. Major clients include banks, investment companies, manufacturing organizations, aviation etc. RahulBhan Credentials
  • 18. 18 RESUMES - Our team  Co-Founder - Riskpro  PGD (Electrical & Electronics & Computer Programming)  30 years of experience in Information & Communications Technology (ICT) Solutions for Retail, Garments, Manufacturing, Services Industries.  Has created Companies, Divisions, Products, Brands, Teams & Markets.  Consulting in Business, Technology, Marketing & Sales & Strategic Planning.  Advisory, Training, Workshops & Implementation in Systems Thinking, Systems Modeling & Balanced Scorecard  Worked with TIFR, Mahindra, Ambience, Communico-Graphique & Ionidea Inc, USA, CasperAbraham Credentials  Sr Vice President – Risk Management  MBA, PDFM,NSE-NCFM, PMP, CSSGB,ISO 9001:2000 I.A,GARP-FBR, ITILV3,CPP-BPM  Professional with 17 years of rich experience into diverse Consumer finance/ Lending operations ,Risk Management,BPMS, Consumer Banking, NBFC, Management Consulting & Housing finance in BFSI industry having successfully led key business strategic engagements across multi-product environment in APAC, Australia and US regions.  Worked with GE, ABN AMRO Bank, Citigroup, Accenture, Deutsche Postbank  Highly skilled and expert Trainer in Risk areas across Credit, Fraud, Operational, Corporate Risk management.  Specializes in Fraud Control, AML/KYC Compliance ,QA ,ERM and Regulatory governance. HemantSeigell
  • 19. 19 RESUMES - Our team  Head - Insurance Risk Advisory services  B.sc, Associate of Indian Institute of Insurance  Licensed Category A Insurance surveyor  26 years of experience in Insurance advisory services, Loss adjusting for large corporates,Claims management.  Has assessed more than 4500 high value insurance claims across various industry sectors.  Risk management inspection  Valuations of fixed assets for insurance purpose. R.Gupta Credentials  Head - Human Capital Management  Chartered Accountant, Lead Assessor ISO 9000, Six Sigma Trained, Trained on Situational Leadership, Trained on interviewing skills and Whole Message Model.  Over two decades of international, multi-cultural experience in finance and human resources viz. internal audit, accounting operations, accounting process review & re-designing, risk management, business solutioning, six sigma projects, talent acquisition, talent retention, organization design/redesigning, compensation and appraisal processing, employee and customer satisfaction surveys, knowledge management and finance services.  Worked with Citicorp/MGF, India Glycol, Delphi, American Express India, American Express USA, Fidelity International and Macquarie Global Finance Services India. NileshBhatia
  • 20. 20 RESUMES - Our team  Head – Taxation Risk Advisory  B.Com, FCA  Senior Partner with 48 year old Delhi based Chartered Accountant firm, Mehrotra and Mehrotra  Over 19 years of experience in the field of Audit, Taxation, Company law matters.  Major clients served are NTPC, BHEL, Bank of India, PNB, Airport Authority of India etc. RajeshJhalani Credentials President – Banking & Financial Services  A senior researcher in Applied Mathematics leading to Ph.D after MSc (Mathematics), CWA, CAIIB  Combined experience of 25+ years in corporate banking, risk management, international trade finance, development of risk rating models, project finance, credit monitoring and NPA management  Since 2006 conducting open / in-house training on the above domains to all Top public/ new and old private sector banks, top MNC banks (India and abroad), leading NBFCs and corporates in manufacturing and financial services space; Worked on IFC (World Bank) funded projects for MSMEs in India and abroad  Worked for Bank of Baroda and ICICI Bank – bestowed Top Performer Award continuously two years during his tenure; widely travelled abroad for business relations, seminars, offering training, investor meetings, NYSE listing and for processes involving establishment of representative Office in USA Sivaramakrishnan
  • 21. 21 Executive Vice President – Risk Management ( Banking & Financial Services)  A hands-on banking professional {BSc (Mathematics), CAIIB} with considerable domestic and international experience  An aggregate experience of 24+ years across industry, mainly BFSI in several functional areas including Retail and Commercial Banking, Corporate Lending, team member of the Business Process Re-Engineering project (BPR); conceptualizing and setting up shared services centres for centralized operations for the Bank in India.  Management through ERM framework overseeing all key areas of the business through various Operational Risk tools like KRI / RCSA matrices. Managing of major project implementation of Basel II and Compliance risk framework  Directing, reviewing and advising Board of Directors on various compliance issues and representing the bank to the Central Bank regulatory offices.  Worked for ANZ Grindlays Bank, Standard Chartered, Bahraini Saudi Bank and Dubai Holdings ( subsidiary) KashiBanerjeeRESUMES - Our team Credentials Consultant – Information Security & IT Governance  LLB, CA, CISA, CWA, CS, CFE and others  Over 15 years of experience in the field of Audit, Taxation, Investigations.  Specializing in the field of Systems Audit, Cybrex Audit, Computer Crime Investigations, IS Forensics  International Committee Member of Governmental and Regulatory Agencies Board and Academic Relations Committee of ISACA, USA AnjayAgarwal
  • 22. 22 Executive Vice President – Risk Management ( Banking & Financial Services)  Professional Risk Manager with considerable domestic and international experience  An aggregate experience of 30 + years across industry, mainly Banking in several functional areas including Wholesale Credit Risk, Operational Risk, Trade Finance , Retail Banking and Islamic Financial Services.  Track record of setting up of excellence in the set-up, and management of credit and operational risk, compliance and credit administration functions in retail, commercial , Islamic Banking and offshore banking entities in the Middle East.  Key strength includes Corporate Credits, Risk Management in IT, implementation of Risk Management module in core banking Bank’s Policies, procedures, Country Risk. Played an active role in 3 core banking software implementations  Worked for a Private Sector Bank in India, ABN AMRO Bank, Bahrain, Bank Muscat Bahrain and BMI Bank Bahrain as AGM Risk Management. VijayanGovindarajanRESUMES - Our team Credentials  Specialist Risk Consultant – ERP & IT Compliance  SAP Certified, MBA (Finance), SAP Security trained (from SAP India), SAP GRC Access Controls trained (from SAP India)  Over 7 years of experience working in the area of ERP/IT Risk advisory, primarily focusing on SAP, for ‘Fortune 500’ clients in around 8 countries including US, UK, UAE, Hong Kong, etc  Specializes in SAP Risk & Controls Advisory, SAP Business Process Controls Audit, SAP Security & Segregation of Duties Control Audit, ERP Trainings,  Strong Industry experiences ranging from Beverages, Insurance, Energy, FMCG, Pharmaceutical, Retail, Telecommunication to IT Services  Worked for risk advisory teams of reputed organizations like Ernst & Young, EXL Services GouravLadha
  • 23. 23 RESUMES - Our team Credentials  Vice President – IT Risk Advisory  Over 14+ Years of Experience in Information Security and Risk Management & CISM certified  Headed the Global Information Security team of Daimler (Mercedes-Benz) Worldwide at Bangalore for 9 years, previously worked at organization like Wipro, Bangalore Labs  Multi-sector experience including Banking, Insurance, Finance, Energy, Manufacturing, Retail, Hi-Tech & Telecom, and Automobile  Well known Ethical hacker: Was featured in BusinessWorld Magazine in an article about leading ethical hackers in India and published several articles in Print and Online Media  Rich experience in Information Security Audits across Corporations, 3rd Party Suppliers, Joint Ventures across several countries in the world including US, UK, China, Germany AashishSrivastavaRavikiranBhandari  Specialist Consultant – Legal Risk Advisory  B.B.A. ,LL.B. (Hons.)  About half a decade experience in legal services to client’s with respect to Contract and Commercial Laws, Joint Ventures, Inbound & Outbound Investments, Private Equity Investment Transactions, Real Estate & Infrastructure, Energy and General Corporate.  Have advised various social enterprises and start ups in setting up business in India.  Worked for the leading law firms of India such as FoxMandal Little.
  • 24. 24 RESUMES - Our team Credentials PhanindraPrakash  Vice President – Riskpro India  FCA [India], ACMA [India], CFE [USA], CertIFRS [UK]  Over 16 years of extensive consulting experience which includes financial & systems audit, process transformation, implementation of internal controls, SOX compliance, fraud audits & due diligence, US-India taxation  Engaged in consulting roles as trusted advisor to finance, internal audit and information technology executives of multiple Fortune 1000 companies with project sites in US, Canada, Europe & Asia  Worked with E&Y and Deloitte Consulting in USA  Some of the major clients served internationally are GE Capital, UBS, McKesson, Eaton, Imation, Albertsons,  EVP and Head – Telecom Risk Advisory  M.Tech (IIT Kharagpur),IES,Doctoral study, research and teaching in Linkoping University/Sweden, Lead Auditor (BVQI).  Over 30 years of International experience in networks and mobile Handsets from top global companies /institutes like ISRO, Ericsson, Nokia, Nokia Siemens Networks based in its head quarter locations in India, EU, USA.  Expertise: Setting up capability, behaviour, culture in turning Risk, Quality, Innovation for competitive advantage, customer delight and sustainability; key skill sets are Engagement, Handholding, Coaching, Mentoring and lot of best practices, benchmarking/standards like CMMI, TL9000, Six Sigma, ISO, SAS 70 etc. AsokSit
  • 25. 25 RESUMES - Our team Credentials SiddharthaGhosh  Executive Vice President – Riskpro India  CPA (USA), ACA, ACS, Grad CWA (India), MBA (USA), Associate ICPAS (Singapore)  Over 25 years of extensive audit and industry experience which includes 19 years with Rolls-Royce India Pvt Ltd at New Delhi and its associate and parent companies of Rolls- Royce in UK, USA and Singapore in all aspects of Finance, Taxation, Audit, Banking, Legal, Company Secretarial, Statutory compliances and due diligence, Internal Control, ESOP, Budgets, Cashflows, Forecasts, MIS Reporting, HR, Expatriate & Office Administration, Payroll, IT, Retirement Funds Administration, Shared Services, Project Accounts, etc.  Worked with Price Waterhouse Coopers for 4 years with reputed MNCs, banks, Indian corporate houses  Worked with McNally Bharat Engineering Company Ltd for 4 years PritiTawari  Vice President – Riskpro India  B. Com, ACA, Dip. IFRS  Over 6 years of extensive audit and industry experience in all aspects of Finance, Taxation, Audit, Legal, Company Secretarial, Statutory compliances and due diligence, Internal Control, Budgets, Cash flows, Forecasts, MIS Reporting, HR, Expatriate & Office Administration, Payroll, IT, Project Accounts, etc.  Worked with Price Waterhouse Coopers for 3 years in audit & assurance for reputed MNCs, Indian corporate houses.  Engage in own practice since 2010 specialize in outsourcing of finance department in mid size MNCs and consultation in Indirect Taxes and Management Reporting
  • 26. 26 RESUMES - Our team Credentials ManojKumar Senior Vice President CAIIB 20 Years of hard core banking experience in India’s most reputed banks across wide functional areas. Worked with Central Bank of India, ICICI Bank, HDFC Bank, and Axis Bank as Asst Vice President, Cluster Head, and Branch Head. Areas of expertise are Financial Risk Management, NPA-Credit-Debt Management, Asset Reconstruction, Project Finance, and others. Accomplished several achievements in the functional areas of banking.
  • 27. 27  Specialist Risk Consultant – Business Continuity  Founder and 15-year Chairman of Survive, the first international user group for Business Continuity professionals  Founding director and first Fellow of the Business Continuity Institute  Over 25 years international consulting expertise in Risk, Crisis, Emergency, Incident, and Business Continuity and ICT Disaster Recovery Management  Multi-sector experience including Banking, Insurance, Finance, Oil, Gas, Energy, Manufacturing, Retail, Hi-Tech & Telecom  Western Press Award for services to business, 1994; BCI/CIR nomination for lifetime achievement in BC, 1999, London; inducted into BC Hall of Fame by CPM magazine, 2004, Washington DC. AndrewHilesRESUMES - PARTNERSHIPS  Specialist Risk Consultant – Enterprise Risk Management  Highly skilled risk and insurance professional with 25 years of experience designing, developing and implementing large, global corporate risk management programs for Fortune 500 firms.  Principal Consultant and Founder - Excellence in Risk Management, LLC. (Texas, USA) Co-founder and EVP, Professional Services, rPM3 Solutions, LLC (Maryland, USA).  Past experiences include Head of Global Risk Management for USAA, PepsiCo/Tricon Global and American National Red Cross  Additional risk and insurance experience at Verizon Corp,. Marsh USA and Liberty Mutual Insurance Co.  2004 Risk Manager of the Year – 2007 recipient of the Alexander Hamilton Award for “Excellence in ERM” (at USAA) – former President, Risk and Insurance Management Society, Inc. ChrisE.Mandel
  • 28. 28 Key Contacts Corporate Mumbai Delhi Bangalore Riskpro India Ventures (P) Limited info@riskpro.in www.riskpro.in F 186, Sarita Vihar New Delhi 110076 Manoj Jain Director M- 98337 67114 manoj.jain@riskpro.in Shriram Gokte EVP - Risk Management M- 98209 94063 shriram.gokte@riskpro.in Sivaramakrishnan President – Banking & FS M- 98690 19311 smaran.iyer@riskpro.in Rahul Bhan Director M- 99680 05042 rahul.bhan@riskpro.in Hemant Seigell SVP – Risk Management M- 99536 97905 hemant.seigell@riskpro.in Casper Abraham Director M- 98450 61870 casper.abraham@riskpro.in Vijayan Govindarajan EVP – Risk Management M- 99166 63652 vijayan.govindarajan@riskpro.in Ravikiran Bhandari VP – IT Risk Advisory M- 99001 69562 ravikiran.bhandari@riskpro.in Ghaziabad / Noida Chennai Kolkata Gurgaon Siddhartha Ghosh EVP - Finance M- 9810058072 Siddhartha.Ghosh@riskpro.in R Gupta - Insurance Risk M- 98101 07387 R. Muralidharan EVP – Risk Management M- 95660 77326 murali@riskpro.in Kashi Banerjee EVP – Risk Management M- 98304 75375 kashi.banerjee@riskpro.in Nilesh Bhatia Head – Human Capital Mgt. M- 98182 93434 nilesh.bhatia@riskpro.in Asok Sit EVP – Telecom Risk Advisory M- 98105 03463 asok.sit@riskpro.in Pune Salem Ahmedabad Hyderabad / Agra M.L. Jain Principal – Strategy Risk M- 98220 11987 mljain@riskpro.in Priti Tawari M- 9011054085 Chandrasekeran Recruitment franchisee M – 94435 99132 Manoj Kumar M – 98983 65320 Maulik Manakiwala M – 98256 40046 Gourav Ladha Phanindra Prakash (Hyderabad) Member Firm M- 95500 61616 Alok Kumar Agarwal (Agra) Member Firm M- 99971 65253