© 2019 by New England Chapter International Association of Special Investigation Units

We hope you enjoy the variety of courses that we are offering at this year's event.  Below, please find a more detailed description of the course and what the instructor intends to discuss.  Don't forget to check out our Speaker Bio page for more information on the instructors, as well as our schedule of events!

Course Descriptions - 2017 Joint Conference

A Fraudulent Water Loss Case Study

This class discusses a case study that involved multiple expert disciplines and a multifaceted analysis.  The case was interesting due to the number of ways in which the water loss was proven to have not occurred as reported.  The analysis, interviews, and data are reviewed in this class explaining the methodology that was used.  This course exemplifies a growing trend of insurance fraud involving water losses.

Jay Kramarczyk

Rideshare Updates

While the insurance industry is just beginning to get a handle on claims involving “traditional” Rideshare services (i.e.Uber/Lyft) , numerous new “auto sharing” companies have emerged which create even more complex  issues for personal and commercial auto insurers. New Rideshare services, such as Turo, Dryver, and HyreCar encourage car owners to hand over their vehicles to strangers in exchange for a fee. New concepts relating to vehicle leasing (i.e. BAMA Leasing/ Xchange Leasing), and rentals (i.e. Enterprise/Hertz) are putting more Rideshare drivers with big financial problems – and incentives – on the road. These new auto-sharing developments raise a myriad of new coverage issues that can plunge insurers into murky waters where permissive use is hard to define, commercial activity is easily camouflaged, and fraudulent activity by both the owner and renter of the shared vehicle may be encouraged. These new auto-sharing enterprises also open insurers to a host of unanticipated liability risks for personal injuries, property damages, and potential theft claims.  Learn about the next generation of rideshare applications, analyze the new exposures facing the insurance industry, and explore how your company can seek to insure only the risk it bargained for.

Audrey Parr & Corinne Taylor

Musculoskeletal Injections, etc.

Overview of course: Discuss and review  spinal anatomy and sources of spinal pain, discuss the main goals of injection therapy, define interventional pain management,  distinguish  the differences between trigger point injections, facet injections and epidural steroid injection and discuss when musculoskeletal injections should be administered

Carolyn Carey

Fireproof: How understanding the recent updates addressing the mandatory investigative principles, methodology and analysis of fire claims under NFPA 921 (Guide for Fire & Explosion Investigations, 2017 Ed.) can keep you from getting burned in the Claims Office and the Courtroom.

This seminar will explain investigative principles, methodology and analysis in connection with fire claims investigations in accordance with NFPA 921 (the National Fire Protection Association’s Guide for Fire & Explosion Investigations, 2017 Ed.) as well the respective roles of claims professionals, SIU Investigators, fire investigators and legal counsel in the effective investigation, evaluation and litigation of residential, commercial and vehicle fire claims.

 

The Attendees will learn about:

 

  • The application of Investigative Best Practices to ensure the timely and comprehensive identification and preservation of evidence so as to allow for a comprehensive and cost-effective fire investigation in compliance with the requirements of NFPA 921.

 

  • The fundamentals of fire investigation methodology, the evolving science of scientific fire investigation, fire investigations “myths”, how the causes of residential, commercial and vehicle fires are identified as well as the meaning and application of concepts and terms used in NFPA 921.

 

  • The technical requirements of NFPA 921 and NFPA 1033 as they relate to the credentials of fire investigators and adherence to proper methodology in order to withstand legal challenges to the admission of expert opinions as to the cause and origin of residential, commercial and vehicle fires.

Dave Stadolnik & Dennis Lyons

Preparing For Depositions

This course is designed to provide insurance investigators, adjusters, and other witnesses with a fundamental understanding of the deposition process and a witness’ obligations pursuant to the pertinent Rules of Civil Procedure once litigation has been commenced. The course will review the basic rules of discovery regarding the deposition process and provide guidelines and pointers to assist in preparing to attend depositions and to effectively testify at them. Attendees will be encouraged to ask questions, express concerns, and to share experiences they may have in attending depositions.

Bruce Medoff

Social Media

Better than Stephenson's class.

Doug Osborne

Today’s World of Fraud; A Forensic Accountant’s Perspective

As fraudulent activity has become an everyday occurrence, we will focus our discussion on the evolution of fraud and the impact on today’s society.   Certain technological advances have been made over the years that have impacted fraud detection.   Metadata, professional fraudsters and online tools have had a major influence on human and corporate behavior.   We will look at the many ways professional fraudsters are creating fraudulent documents and what you can do to help detect fraud. 

Charles Amodio

Selection of Experts, Identifying Actual v Misleading Qualifications

The insurance professional is immediately charged with a multitude of responsibilities following a loss, including mitigating the loss, determining coverage, and determining whether it is an insured loss, and whether another party may be responsible or may share in the responsibility for the event. The insurance professional must quickly determine the scope of the loss in sufficient detail to identify required expert competencies. Although the required investigation may be beyond the professional’s education and skills, the expert selection is not.  Once the insurance professional recognizes an expert is required, the professional must define the event in sufficient detail to determine what expert capabilities are required. Capabilities include licensure, certifications, knowledge, experience, skills and competencies.  

This course will provide the professional with tools necessary:

(1) to recognize the need for an expert,

(2) to define the loss significantly to determine the expert competencies required,

(3) to select an expert who meets the required competencies.

(4) to evaluate the expert’s performance during the investigation, and  

(5) to insure the investigation was conducted properly, opinions are scientifically based, and the opinions are accurate and defendable for possible litigation.

R. Craig Williams

What Makes a Good Case for Prosecution

Building a Strong Criminal Case from a Prosecutor’s Perspective

Stephen Adams

Images Don’t Lie: 3D Imaging, Stemming the Growth of Exaggerated Injuries

I. 5 Recent Trends Increasing the Rate of Exaggerated Injury Claims
   a. Changes in U.S. healthcare and medical reimbursement
   b. Exponential growth of outpatient orthopedic surgical centers
   c. Advancements in medical technology
   d. The Internet and accessibility of information (e.g. police records)
   e. Collaboration between medical service providers
II. The Psychology of a Plaintiff Attorney 
   a. How the brain works, how we process information (visual learners)
   b. How a plaintiff attorney thinks, his/her motivations and constraints
   c. Key leverage points
III. How 3D Imaging works and use in medicine
IV. 3D use and application in the medical-legal field
   a. History of usage with insurance carriers
   b. Usage by plaintiff attorneys (in case you see it)
   c. Case studies
   d. Case selection and “The Perfect Case”
   e. Admissibility
   f. Other considerations
V. Q&A

Jorey Chernett

Workers Compensation 201

Workers Compensation investigations, particularly those involving fraud, can be complex and might seem daunting.  But with the right structure, an investigator can acquire information that allows their company to make the best possible decisions while putting together a strong case for the authorities.  This presentation will look at varying aspects of a WC investigation, including the wage replacement system (no pain & suffering), types of benefits, the WC administrative system, how best to conduct an investigation including recorded statements & pictures, defining subrogation potential, looking at earnings reports, how to deal with employees who are working while collecting, false statements under oath, and how to best prepare criminal referrals.

Nicholas S. Chrissis

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Combating Low-Impact Insurance Claims

Frustration is what we hear, throughout the industry, when confronting bodily injury claims emanating out of low-impact collisions.  The damages are so minor that common sense screams no one could have been injured.  Yet, insurers settle these claims every day, for substantial sums, because liability is clear or they want to avoid litigation expenses.  This presentation will provide a process for which to attack these suspect claims at an early stage, with a consistent investigative and dispositive strategy.  Focus is not centered on the analysis of medical records concerning treatment of subjective complaints of soft-tissue injuries.  Rather, this presentation will assess the element of “causation” and the credibility of the claimant.  Attendees will be provided with a clear game plan on how to approach these claims that will contain costs, reduce indemnification and avoid litigation.

Adam Brand & Tim Tapply

MARIJUANA - Legal – Illegal – Medicinal – Recreational - Insurance Claims Coverage Issues

Are issues involving claims for coverage involving marijuana up in smoke?  State Laws and Federal Law are in conflict concerning marijuana.  How is this conflict resolved?   At least 28 states and the District of Columbia have enacted medicinal marijuana laws.  A number of states have legalized recreational marijuana.  How does this state legislation impact insurance claims? Where does your company policy specifically address marijuana claims?  How has the Department of Justice reacted to state laws involving both medicinal and recreational marijuana?  Is marijuana a crop?  What is the standard measure for impairment by marijuana?  How do you value marijuana?  How is your company adjusting marijuana claims?  Given these issues – we need to talk!  Come and join this discussion, you will not be disappointed.

Jack Parenteau

Using Vehicle Location Information for Fraud Analytics & Investigations

“Where” data or location data is changing how people and companies do business. For SIUs, that “where” data in the form of vehicle location data is delivering on the promise to fight fraud. How? By providing proof where other data falls short. Vehicle location data provides the answers and evidence to SIU questions like: Does a person live where they say they live? Was there damage to a vehicle before the claim? Learn where vehicle location data comes from, how it differs from other data types and why policyholders don’t have to opt in. Walk through detailed examples of the top ways SIUs use vehicle location data including: Identify Garaging Fraud, Detecting Pre-Existing Damage, Confirming Alibis, Uncovering PIP Fraud and Workers Comp Investigations. Get perspective and statistics on how carriers are using vehicle location data and analytics, and understand how the data fits within the SIU investigative process.

Alex Young

Best & Worst Practices for Conducting Recorded Interviews

Claim handlers and special investigators take recorded interviews of insureds, claimants and witnesses to obtain information with which to makes a claim decision.  If a claim merits an interview, the interview should never be perfunctory.  Attend this session to review and critique actual recorded interviews and to learn about the best and worst practices for taking useful interviews. 

Roy Mura

Opioid Investigation & Prosecution

Course Description: We will provide an overview of an illegal prescribing investigation from beginning to end covering the following areas:

  •          Initial Investigative Steps

  •          Data Review

  •          Approaching the Target

  •          Reviewing Records

  •          Hiring and expert

  •          Trial Prep

 

Main takeaways: Tips on how to review data and medical records and the importance of consulting with medical guidelines and medical experts.

Steven Hoffman & Chris Cecchini

It Floats, It Rolls, It Digs…Now What?

A review of “non-standard” claims and resources for attendees; i.e., theft, fraud and identification issues with boats, ATVs, snowmobiles (items which could even be covered under a homeowner’s policy,) small pieces of specialized equipment used by contractors. Resources to verify VINs, HINs, PINs of non-standard items, dealer information, recalls, identification, and resources which may aid law enforcement in recoveries of non-fraudulent thefts. The value of these claims can vary from $5000 for a standard ATV to $18,000 for a UTV or $35,000+ for a boat or equipment; such as a mini-excavator, skid steer, or contractor’s trailer with tools inside.

Heidi Jordan

Recent Developments in PIP Litigation

The seminar will focus on recent case law which affects the handling of Personal Injury Protection (“PIP”) claims, including decisions relevant to successful claim handling, specifically the coordination of benefits with health insurance and PIP, as well as the mandatory Med Pay endorsement regarding duplicate payment. Cooperation requirements under the Standard Massachusetts Automobile Policy pertaining to independent medical examinations and examinations under oath, as well as, the cost containment measures of preferred provider agreements, and usual and customary fee review will also be addressed.

Jodi Conners

The Role of Ethics in a Complex Investigative World.

The session will be “The Role of Ethics in a Complex Investigative World.”  We will be using interactive response technology during the session (everyone will have fun with this).

R.A. 'Andy' Wilson

Vehicle Infotainment & Telematic Systems-The Cutting Edge Source of Vehicle and Occupant Data

Did your driver pair their phone with the Bluetooth system in their vehicle? Did they connect their phone to the USB port to charge their device? Does your vehicle have a navigation system that tracks location information…even when the navigation system is not in use? The years of digital information that vehicles are storing will certainly surprise you…and can help solve your case.

 

Vehicle Systems Forensics offers a new look into the actions of vehicle performance and driver interaction with the digital world inside of their vehicle. Vehicle infotainment and telematics systems store vast amounts of data such as recent destinations, SMS messages, call logs, favorite locations, contact lists, emails, pictures, audio, social media feeds, and, if equipped, the navigation history of everywhere the vehicle has been. Many systems can even store when and where a vehicle’s lights were turned on, when and where specific doors were opened and closed, when and where Bluetooth devices were disconnected (including the phone number of the Bluetooth device that was paired!), and odometer readings with date and time histories.

Shawn Harrington

Fire Forensics – Methodology and Hypothesis Testing

Insurance professionals and attorneys make determinations to resolutive fire events. In order to make informed decisions, the professional must have a working understanding of the fire investigation and resulting origin and cause opinions.  The professional makes expert retention decisions based on his understanding the fire investigative process. The better this understanding, the better able the professional is to understand, and evaluate his expert’s opinions (as well the opinions of experts employed by other interests).  This seminar begins with a discussion of what fires are, how they are able to ignite, what is necessary for a fire to be sustained, and spread the fire spread affects evidence. What is left behind once the fire is extinguished becomes the physical items which may be evaluated.  This seminar will discuss the accepted standards and requirements for the collection and preservation of information and physical items. Examining the physical evidence and other information will lead to the requirements for the evaluation of this scientific data. The methodology will include a discussion of the scientific method, why this methodology is important, and how a hypothesis is formulated and then tested (accepted or excluded). Once this information is provided, the professional will be provided tools by which the opinions may be evaluated for: accuracy, repeatability, and the ablility to withstand rigorous challenge. Pictures, statements, and evaluations from actual fire investigations will be used to provide examples of presented methodology.

R. Craig Williams

The Mobile Device: The Center of the Fraud Prevention Universe

Nearly six billion data records have been compromised since 2013, fueling the activity of key organized crime rings. As a result, personally identifiable information (PII) and login credentials are no longer seen by insurance companies, financial services and merchants as reliable means of identifying customers. The bad guys are winning. 

At the same time, fraud executives face intense internal pressure to ensure that their risk controls don’t have a negative impact on the customer experience. While this creates a daunting backdrop, a promising new vision is emerging – centered around the customer’s mobile device – that balances strong mobile fraud prevention with a delightful customer experience.

What are the three main points that attendees will take away?
1.    How to leverage the mobile device to not only better secure mobile channel transactions but also add mobile security and enhance the user experience in all other channels.
2.    How to harness valuable data and convert it into actionable intelligence.
3.    How to plan for continued investment in remote channel security.
 

Eddie Glenn

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