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Course Descriptions - 2019 Joint Conference

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!

Driving Digital Healthcare Interaction into the Mainstream

The increased popularity of applications like FaceTime and Skype may be the catalyst to push digital interaction with healthcare providers into the mainstream. And this social norm is coming at the perfect time. Telemedicine technology which allows health care professionals to evaluate, diagnose and treat patients in remote locations, is a much talked about advancement that could help in an era where access to care is of concern.  In this session we will explore the applicability of telemedicine in workers’ compensation and how it compliments nurse triage.  In a healthcare reform era, facing physician shortages and other market pressures, the opportunity for providers and patients to discuss and diagnose conditions could have substantial impacts on access to care, cost containment and improved productivity.   Attendees will be able to learn the definition of telemedicine versus telehealth and explore how both nurse triage and telemedicine together can ensure injured employees are assessed at the time of injury for the most appropriate level of care and provided with access to a board certified physician when treatment is needed and also to learn when telemedicine makes the most sense.

Tammy Bradly, VP of Clinical Product Development, Coventry

Identifying the Imposter

This program is a Universal Law Enforcement Identity Theft program that will assist you in identifying the presence of an Impostor. Anyone for whatever reason who steals the real identity of another person can potentially be identified and located using this new investigative technique. This presentation will teach participants a new and dynamic method of identifying Identity Thieves aka Impostors using multiple State and Federal databases.The instructors will focus on foreign national impostors using stolen identities to hide in plain sight and commit various offenses in the New England area.  The attendees will learn how to detect the accuracy of the information supplied by the insured when obtaining a policy.  The presentation will be co present with NICB Agent, Mark Huard, who will show attendees how NICB can be utilized as a resource in these types of investigations as well as a referral resource when these issues have been identified. The techniques used to investigate and confirm VINs on insured vehicles will be used to show how the same techniques can be utilized to identify the identity of the insured. Discussion of statistical data to demonstrate how important it is to assess the proper risk on a policy.

Officer James Scott, Saugus Police & Special Agent, Mark Huard, NICB

Automobile Finance Fraud – Automobile Straw Purchasing

The course is designed to demonstrate how auto finance fraud, used car dealer fraud, and automobile straw purchasing is the new face of auto theft.  This activity is often miscategorized by financial institutions and insurance companies as an identity theft or credit loss and is routinely considered by law enforcement as a civil matter.  The course will show clear examples of organized criminal activity, money laundering, and insurance fraud on a local, national and international scale.  The presentation will discuss many fraud related crimes with real examples from New Jersey cases involving vehicles, such as subleasing scams, title fraud, identity theft straw buyers and why they should be considered criminal offenses as opposed to civil matters.  The attendees will learn the essentials of automobile fraud/automobile loan fraud and the definition of straw buyer and the red flags when investigating these cases.  Sgt Pyrzanowski will discuss how to identify fraudulent documents such as fake pay stubs and terms used in investigating Loan Fraud with concentration on fraud in the loan application.  The course will show how loan fraud is often the foundation to insurance fraud and other financial crimes.

Detective Sergeant Jarek Pyrzanowski

Medicinal and Recreational Marijuana

Updates on coverage issues related to medicinal and recreational marijuana as well as the sale of insurance to medicinal and recreational dispensaries.  What position is your company taking regarding selling policies of insurance, as well as coverage issues which are arising in the rapidly emerging marijuana market.  While states are enacting laws allowing both medicinal and recreational use, federal law still views it as a controlled substance.  Is your company selling insurance to this industry? If not, why not? What types of coverage are being offered? General Liability Coverage?  Business Owner Coverage?  Professional Liability? Medicine Coverage?  How about Workers’ Compensation Coverage?    What position are federal prosecutors taking with regard to medicinal and recreational facilities in view of the fact that state laws are allowing these businesses to operate? Attendees will learn the coverage issues arising in the handling of marijuana claims; the differences between state and federal law related to marijuana; and what type of insurance policies are being sold to the marijuana industry.

Attorney Jack Parenteau, Founder/Partner, Parenteau & O’Hara, P.C & Attorney Diana D O’Hara, Founder/Partner, Parenteau & O’Hara

FBI’s Theft of Trade Secrets, Counterfeit Goods Trafficking, and other Intellectual Property Rights (IPR) criminal infringement investigations

UC Shapiro will provide an overview of the FBI’s Theft of Trade Secrets, Counterfeit Goods Trafficking, and other Intellectual Property Rights (IPR) criminal infringement investigations.  He will also highlight a profile of counterfeiters with a particular focus on actors engaged in the manufacture and trafficking of counterfeit pharmaceuticals.  UC Shapiro will also highlight the structure and mission of the National Intellectual Property Rights Coordination Center.  Attendees will learn the latest trends in counterfeit pharmaceutical trafficking as well as the best methods for collaborating with law enforcement on criminal investigations and community outreach. 

Steven Shapiro, Unit Chief, FBI Intellectual Property Rights Unit

The First 24 Hours: A Look at Emergent Fraud Schemes in Ambulance, ER, and Urgent Care Billing and Services

Research shows that while the number of emergency room visits have declined, spending in emergency room fees continues to increase.  This presentation examines deceptive billing practices committed by ambulance companies, emergency room providers, and urgent care clinics.  An understanding of the deceptive billing practices utilized by these emergency care providers will assist claim examiners and investigators to detect fraudulent charges.  Attendees will be able to identify deceptive billing practices committed by emergency care providers and understand relevant billing codes and fees contained in medical records and bills submitted by emergency care providers.

Attorneys Doug McInnis and Marykate Williams, Morrison Mahoney

Investigations in the Digital World

Every investigation involves connecting the dots between people, objects, places and events. Understanding the abundance of data available through technology is vital to any modern investigation.  This session will educate you on the limitless possibilities and the value added to any investigation through the lawful use of digital forensics and open source investigations to include mobile device and computer forensics and the proper navigation of the Surface Web, Deep / Dark Web and Web 2.0.

Rich McKeon, CCE., CSMIE; Partner at Cyfortec Group

Cell Phone Tracking and Analysis with NICB using GEO Time

Attendees will learn how NICB uses cell phone data in our investigations.  The basics will be covered of cell phone data and terminology and discuss data challenges.  Also, there will be a brief product demo of the GeoTime and GeoTime Call Records Tool software to show how the data is processed, analyzed, and visualized.  Case studies will also be discussed that show how the NICB used this data and software to create products that helped contribute to successful arrests and indictments. Attendees will learn the basics of cell phone data and terminology; understand the basics of the GeoTime Call Records Tool that is used to process raw cell phone data files and understand the basics of the GeoTime software that is used to map records and provide 2D and 3D data visualization.

Jeff Rasmussen, Senior Tactical Analyst, National Insurance Crime Bureau

Fraud and Crime in the Marine World

Fraud and crime in the marine world exists.  From the theft of high valued outboards and marine electronics by Cartels to the more mundane “slip and falls” at marina docks and piers, fraud is ever present.  This course will review theft trends, vessel theft and identification and marine based fraud schemes.  We will review ocean marine, recreational and inland marine topics ranging from high seas incidents to over the road transportation fraud.  

Daniel Rutherford, Director, Claims & Risk Management

Digging up Dirt – Utilizing 3rd party data to gather suspect and incident information

Have you ever been able to pick a suspect or witness out of thin-air? We can provide you with introductory material on how to perform search techniques that utilize information gathered by private corporations. Using differing techniques, this information can be obtained and used by private and public sector investigators to further their investigations – or even develop leads in a case where they may not otherwise exist. This training will primarily focus on new techniques utilizing Google geo-fence locations searches and reviewing user account data. It will also incorporate preserving and pinpointing user locations with new forms of cellular service provider data.  We will also discuss techniques that can be used to further your investigations when there is a known suspect, such as Google Takeout, Google locations, and other types of information that can be gained from certain apps.

Detective Sergeant Aimee Moller – Plymouth NH Police Department and Matthew Wilmot, CFEI, NH State Fire Marshal’s Office

Identity Theft

Discuss Identity Theft vs identity fraud, how identities are assigned and different ways in which they are compromised. Tonya will discuss investigative techniques used to investigate these crimes and highlight a few investigations her office has done in the past.

Tonya Perkins, Special Agent in Charge, Boston Field Division for the Social Security Administration, Office of Inspector General

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Overview of Fire and Explosion Investigations

Trooper Spahl will discuss an Overview of Fire and Explosion Investigations including the Scientific Methodology, Evidence Collection, Case Studies, Working with the Public Sector.  He will also have an Accelerant Canine Demonstration.

Massachusetts State Police Trooper, Gregory Spahl

Infotainment As it Works with Staged Thefts

Erin and Mark will discuss updates/refresher on infotainment/data extraction.  Additionally, they will discuss the various cases that they have implemented the use of infotainment data.  Further discussion will be on various types of claims that infotainment can be used in; how it is presented to law enforcement and Success Stories on Current Cases.

Erin Bracken,CFE, AIC SIU investigator, Zurich North America Claims & Mark Charriez, FCLA, Sr Investigator, Zurich North America’s SIU Major Case Team

What’s your Medical Fraud IQ?

SIU’s and claim adjusters have been working on medical fraud cases for years.  They have attended training sessions and worked cases making them familiar with FWA (fraud waste and abuse).  They have developed methods to detect, analyze and prevent fraud. 

This session will review key factors found in questionable medical practices and questions will be posed to share experiences and techniques to detect medical fraud.  Attendees will take away an update on current medical fraud trends, and hear how to make their investigations more effective.

Bonnie Parenteau, RN & Kimberly A. Giardina, Principal Investigator, SIU AIG

Ethics

Attorney Stadolnik will present “Ethics and a Movie” outlining how to Navigate the world of fraud investigation which often presents a wide spectrum of potential ethical traps. The dramatic advancement of technology has presented additional hazards and increased the need for investigators and claims professionals to consistently exemplify the highest standards of professional conduct.

Where can we look for reliable lessons in recognizing and confronting ethical dilemmas? To Hollywood, of course. In this presentation, attendees will analyze a broad array of ethical challenges through the themes explored in popular movies. Specifically, this presentation will include the development of ethical theory and the “language of ethics”, analyze the IASIU Code of Ethics in the context of real-world challenges and illustrate ethical excellence and “Ethical Fails” as depicted in timeless film classics.

Attorney David Stadolnik, Law Offices of David C Stadolnik, LLC.

Investigation to Litigation

The presentation will introduce the method of collecting evidence during an investigation and the critical role of investigators and adjusters alike.  It will allow attendees to look at the evidence collected during the investigation and whether it will be admissible at trial.  Also, will all that work be without reward or will your efforts win the day.  This presentation will discuss strategies in collecting information/evidence during the investigation to ensure its admissibility at trial.  This presentation will also address how the decisions made during an investigation will impact the litigation and provide you with best practices to keep you from a tough day on the witness stand.

Attorney Tim Tapply and Adam Brand

Metadata: SIU and Legal Implications

Electronic data can be a treasure trove of information, the impact of which on an investigation is often significant.  However, without knowing what information is available, how to collect it, the importance of proper presentation, and the impact on litigation, the value of that electronic data may never be known.  Brand & Tapply, LLC along with Techfusion will provide guidance and information on the availability, collection, and preservation of metadata in an SIU, claims, and litigation context.

Attorney Tim Tapply and Alfred Demirjian, President, CEO, Techfusion Corp.

Vehicle SIU BERLA & Electronic Data Recorders and SIU Investigations

The presentation will describe what can be expected through harvesting of data from both the EDR and infotainment systems of supported vehicles.  The presentation will also examine actual cases where the downloaded information assisted the adjuster/investigator in their investigation of possibly fraudulent claims.  This data is on the cutting edge of technology and has been hugely valuable to SIU and VAR experts and claims handlers.

Tony Cretella, Sr. Forensic Analyst/VAR Group, EFI Global

Water Loss Fraud

This is a case study surrounding a water loss claim, which will show several different red flags and the methods used to determine this case was fraudulent.

Jay Kramarczyk, MS, PE, CFI, Senior Principal Engineer & District Manager, EFI Global, Inc.

Arson Case Study

This is a case study surrounding an arson case, including details of the site exam, analysis, and trial, including some of the trial tactics for the prosecution and defense.  This particular case study involves various facets of fire investigation and engineering to dispute the defense attorneys and experts.

Jay Kramarczyk MS, PE, CFI, Senior Principal Engineer & District Manager, EFI Global, Inc.

The Anatomy of a Criminal Insurance Fraud Case at the Insurance Fraud Bureau

This interactive session will discuss the Anatomy of a Criminal Insurance Fraud Case at the Insurance Fraud Bureau - from the initial referral through prosecution.  Presenters will discuss common trends and prosecutorial challenges faced by the IFB’s Community Insurance Fraud Initiative Task Forces (CIFI) and touch on issues confronted by the IFB’s general, premium and provider units. It will conclude with an explanation on how to submit a referral to the IFB.  Included will be changes to the IFB method of operation. This is your opportunity to ask questions of the IFB that you wanted to ask but never had the chance.

Anthony DiPaolo, CFE, Chief of Investigations, IFB & Attorney Stephen Adams, Investigative Counsel

Rideshare Reimagined: New Risks for Insurers

Transporting food, booze, groceries, dry cleaning, flu shots, medical services, etc….  Sharing cars, apartments, RVs, kayaks, construction tools, etc….You name it, your insureds will deliver it, rent it, or share it- and will expect you to provide coverage for them when things go wrong ---  come learn about the latest “sharing” trends to assist you in the adjustment and investigation of your claims.  This presentation will update the attendees on the latest traditional rideshare issues and explore the newest risks facing insurers in our ever-expanding “gig” economy. 

Attorneys Audrey Parr & Corinne A Taylor Parr Law PC

Internet Jewelry Purchases: Smokin’ Deal or Smoke and Mirrors?

Seduced by low prices and convenient comparison shopping, consumers are increasingly turning to the internet to buy their diamonds, gemstones, and watches – but are those prices too good to be true? This course explores the opportunities fraudsters are exploiting through the public’s growing trust of online jewelry markets – including bait-and-switch schemes like high-end fakes and the passing off of less-valuable copycats as expensive gems – as well as the ways online second-hand markets such as eBay and Craigslist increase exposures to insurers through over-inflated valuations, improper identifications, and false theft claims.  Attendees will learn what steps they can take to protect against insuring imitation goods under Homeowners Policies, paying out overvalued or fraudulent claims, and how to develop best practices for jewelry underwriting.

Attorney Corinne A Taylor, Parr Law, PC

Understanding SIU Immunity and Fraud Reporting Statutes in New England

SIU immunity and reporting statutes have been on the books in most New England states for decades. The specific language set forth in these statutes, however, varies greatly from jurisdiction to jurisdiction.

This workshop will review the terms and operation of these important laws. The program will highlight the dramatic differences that exist from state to state.  It will also analyze court decisions interpreting the impact of these rules.

The presentation will focus on how SIU professionals can use the protections afforded by immunity statutes to help them conduct effective investigations, while simultaneously, limiting liability for insurance carriers.

David O. Brink, Esq., Smith & Brink, P.C.

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 - Attorney/Managing Member, Mura & Storm, PLLC

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