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

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

“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

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

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

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

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 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

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

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

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