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

Course Descriptions - 2020 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!

The Key to Success is Teamwork and Communication

In order to have continued success in the fight against insurance fraud there needs to be teamwork and communication.  Tony will talk about the progression of the Insurance Fraud Bureau of Massachusetts and will exemplify its need for strong partnerships with the insurance industry.  A quality investigation requires, and will always require, evidence that can only be developed by communication.

Anthony M. DiPaolo, CFE, Deputy Executive Director, Chief of Investigations, Insurance Fraud Bureau of Massachusetts

Tips, Updates, Best Practices and Q&A

This session is designed for claim professionals. This session discusses new ISO Claim Solution key features, functionality and best practices that will allow you to investigate claims more effectively.

 

Upon completion of this session, the participants will be able to:

•          Investigate the data displayed in the Visualized ClaimSearch report

•          Analyze the interactive visual timeline

•          Utilize the Visual Risk Indicator and Adverse Carrier Alert

•          Effectively use the Claim Alerts Business Intelligence  Dashboard

Kevin Rawlins, Director Customer Engagement at Verisk (ISO)

The Strike of Lightning: Fact vs. Fiction

Summer storms can cause lightning strikes and lightning strikes can cause damages to electrical systems.  Contrary to what people typically think, lightning is much more complex and may not directly harm electrical systems and, in many cases, is not the cause of damages.  During this fact vs. fiction discussion, attendees will learn what to look for and the differences between lightning damage from the surrounding area, typical wear and tear, and a direct strike.  The presenter will discuss common systems affected such as HVAC, telecom, computers, smart home systems, security systems, and more.  Following the discussion, attendees will be able to use this information to help understand the likely cause of the damage.

Paul Mullin, PE, CFEI District Manager of Envista Forensics

Optimizing Surveillance / Surveillance & the Law

This course provides an introduction into the professional and practical considerations involved when an insurer utilizes or engages in the use of video surveillance to combat fraudulent personal injury, disability, and worker’s compensation claims.  The course also apprises insurance investigators, managers and claims adjustment professionals of the legal minefields that exist and important factors to be considered when contracting covert surveillance work.

Robert D. Molnar, Owner/Vice President of Lemieux & Associates

Identifying and investigating Nomadic Activity

This presentation will cover the history of Nomadic activity, how to identify these types of claims, tips to investigate the claims, who you can contact in this specialized field of investigations and how to work with the claims department/law enforcement.
            

Erin Bracken, CFE, AIC, SIU Investigator with Zurich North America Claims

Current Financial Fraud Trends in the New England area and beyond

This presentation will cover current financial fraud trends, which are taking hold of the New England area, as well as around North America.  Dive into financial fraud to uncover how the suspects utilize various means to make money.

Detective Brian O'Connor, CFCI, CCCI Cyber/Electronic Crimes Unit - Financial Crimes Cambridge Police Department

Public versus Private Fire Investigations (Goals and Ground Rules)

This presentation will cover issues frequently encountered by insurance investigators and those charged with investigating fire related insurance claims simultaneously with law enforcement personnel. The discussion will  describe best practices when coordinating such investigations; and describe how to avoid problems encountered during such investigations.

Attorney Bruce Medoff, Smith & Brink, P.C.; Attorney William Tait, Jr., Smith & Brink, P.C. and Captain Paul Zipper, Ph.D, Mass State Police

Motor Home, Travel Trailer, and Motor Vehicle Water Damage Analysis

This presentation will explore the causes of water intrusion and related damages to motor homes, travel trailers, and motor vehicles. It will help distinguish damage caused by wear and tear from damage caused by an accidental loss. It will also address water ingestion of vehicle engines to distinguish accidental losses from intentional fraudulent acts.

Dennis Lyons, SD Lyons

Physical Therapy 2020, what's new, what's old, and what doesn't change

Physical therapy is an ever evolving health profession.  This presentation will focus what Physical therapy looks like in 2020 and how this impacts the services that insurance carriers are being asked to reimburse.  Topics in this talk will address the consolidation and expansion of physical therapy practices, including the arrival of corporate practices and their service delivery models; student debt and its impact of where new therapists may practice; telehealth; non-traditional practice models; and other relevant areas. 

Bruce Levine, PT, MS, OCS

So You’re About to Be Deposed (Or Violently Overthrown): How Should You Prepare & What Should You Expect?

The claims professional and special investigator have done great work in investigating the reported loss  and resulting claim.  Your investigation fully supports your company’s claim decision, but now the claim has gone into suit and you are about to be deposed.  How should you prepare and what should you expect?  Attend this class and avoid undermining your company’s defense by inadequately preparing for or imprecisely testifying during your deposition. 

Roy A. Mura, Esq. Mura & Storm

No Frills Fraud Fighting

There is nothing more disheartening than having your intel waste away because of financial concerns. This presentation examines the options available to you to effectively and economically use intel you have gathered to combat ongoing fraud and advance the investigation. Through the exploration of various anti-fraud reporting and litigation topics and the sharing of best practices, we hope to assist you with sharpening your existing skills and learn the techniques necessary to successfully utilize the fruits of your labor. We will discuss developing intelligence to further the investigation and bolster the defense of BI Suits;  reporting fraud to Professional Boards, IFB, NICB; and discuss the “Minor Case” affirmative litigation approach to combating fraud.

Attorneys Douglas McInnis and Marykate Williams, Morrison Mahoney, LLP (Boston Office)

OSINT Techniques for Fighting Insurance Fraud

Jake Creps a renowned OSINT expert will be dissecting and explaining new open source investigative techniques that will help SIU investigators expedite their claims investigation process. 

Jake Creps, Project Manager for Skopenow

Recorded Statements Reimagined: Time to Toss that Outline!!

An updated approach to taking effective statements - whether on the phone, in person, attorney repped, or using interpreters. Come experience firsthand new practical techniques in action.  See and hear what works and what doesn’t –  Learn specific strategies for handling specific claims issues– garaging, unlisted operator, theft, rideshare,  liability, injuries, etc.. Discover how to appropriately elicit valuable information and evidence that will assist your investigation, and will serve to support the defense of a potential claims denial.”      

Attorney Audrey Parr, Parr Law, PC; and Suzette Cavanaugh, Sr Investigator, Special Investigations Unit, Pilgrim Insurance.

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“LAW & DISORDER- SIU” – Ethics course

The practical application and potential legal consequences of the IASIU Code of ethics will be explored by following the wacky investigative shenanigans of fictional Investigator Babette Bavanaugh. Learn from Babette’s hilarious mis-steps how not to handle ethical challenges.

 

Attendees will:

  • Review the development of ethical theory and the practical and legal advantages of ethical conduct in SIU Investigations

  • Analyze the IASIU Code of Ethics in the context of real-world scenarios and,

  • Recognize breaches of the Code of Ethics as illustrated by Babette’s wacky antics while she blunders her way from one ethical disaster to the next

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

It’s About The Process

The loss site is where fact gathering begins. Establishing the cause of a loss is the foundation of claims investigations.  We will review some of the basics of building the case from the scene: Working with expert witnesses, documenting the scene and coordinating the details for further investigative activity.

Paul Mahoney, Mahoney and Associates

Social Media Discussion with the OSINT Millennial

Come discover new ways of searching for social media profiles in our constantly changing online world using strategic OSINT techniques.  In this session, we will discuss new ways finding information on the usual sites like Facebook and Instagram, but also touch on some new sites like TikTok and Venmo.  Social media and other OSINT findings have proven to be incredibly helpful in an investigation, so it is important to be up to date on the latest tricks and trends.

Melissa Sweeney, Investigative Analyst, Crum & Forster

“Keeping Up With The Criminal Mind” – Trends and Resources

This course will be an overview of property/casualty insurance crime trends impacting the insurance industry. Attendees will learn:
1.    An awareness of the current insurance crime trends, and how they’ve evolved.
2.    Case examples depicting the role of SIU and the many other entities it takes to resolve a case.
3.    A review of resources to be utilized in an SIU investigation.
4.    The ability to become more proactive vs. reactive.

Heidi Jordan, Senior Special Agent, National Insurance Crime Bureau (NICB)

Technology in Collision Reconstruction

The last several years have seen explosive growth in the technology available to the collision analyst, changing the way reconstructions are completed.  The greatest technological advances have come in the form of digital data.  This data can be retrieved from various systems within the vehicle following collisions.  Vehicle event data recorders contain pre-crash and post-crash data including vehicle speed, braking, engine RPMs and steering.   Vehicle infotainment and telematics systems contain data that is beneficial to the collision reconstructionist and investigators of automobile related crime.  This data can include music and media files, cell phone contact lists, text messages, wireless connections, vehicle data and GPS data.  
In addition to the technology advances in vehicles, measurement techniques have advanced in collision reconstruction.  Tape measures have been replaced by total stations, survey grade GPS, laser scanners, photogrammetry and drones.  Using the data acquired by this equipment, a collision reconstructionist can create high-definition images, 3D models, simulations and animations of collisions and crime scenes.  
This presentation will include an outdoor drone demonstration.  

Timothy E. Dowd Senior Consultant/Vehicle Accident Reconstructionist Rimkus Consulting Group

Material Misrepresentation: Targeted investigation to prove materiality

While investigations into application misrepresentations are common, proving materiality of a misrepresentation at trial depends entirely on a quality and targeted investigation and coordination with underwriting.  So many quality investigations that seemingly prove misrepresentations in the insurance application are undone by an inability to prove materiality or to prove that a representation was actually false.  As an industry we often fail to understand the interplay of misrepresentations and materiality and how to prove both.  This seminar will discuss best practices for undertaking a quality and reliable investigation to ensure the results are valid and sufficient for trial.

Attorney Timothy W. Tapply, Brand & Tapply, LLC

Biohazard Cleanup: A fraud in the making

The cleanup of a biohazard situation, whether it be rodent infestation or dead bodies, is an unenviable task on the best of days.  As an industry we have regularly paid exorbitant biohazard invoices with a shrug of frustrated acceptance.  But, such ambivalence has now bread a cottage industry where biohazard firms are taking advantage of carriers who do not know and who do not want to know the full extent of the work performed.  The bills for biohazard cleanup regularly include massive charges for whole building remediation even when the biohazard is contained to a single room.  The charges are unregulated, astronomical, and regularly paid without question.  Now, many biohazard companies are going so far as to offer their services for cash to an insured at a rate typically less than 10% of what they charge an insurance company for the same charge and regularly demand an insured enter into a confidentiality agreement whereby the insured is precluded from discussing their knowledge of the biohazard company with the insurance carrier.  This presentation is designed to educate SIU and claims in the best practices of investigating these claims and developing evidence to combat the legitimacy of the biohazard invoices, identify the true scope of work and damage, and defeat the claimed reasonableness of their invoices.  

Attorney Timothy W. Tapply, Brand & Tapply, LLC

A,B,C Compounding

The proposed presentation will focus on emerging trends in the submission of prescription drug reimbursement with a focus on pain patches, creams and compounds.  Topics to be covered include letters of medical necessity, drug pricing and re-pricing, reimbursement rates, fee schedules, conservative treatment and alternatives.  The presentation will provide a high level explanation as to considerations in claim review involving prescription drugs and methods for combating the same.  A basic overview of related drug testing and urinalysis will also be included.

Attorney Shauna Sullivan, Smith & Brink, P.C.

Informant Work in Medical Fraud

How many times have you heard people say they'd be good as undercover agents?  On medical fraud cases it's complicated.  This presentation will show how to find details, facts and missing information for successful undercover operations.  

Bonnie Parenteau, RN and Brendhan Harris, Chief Fraud Investigator for the New Hampshire Insurance Department; Tammy Noyes Renkowitz

Interviewing 101

Interviewing is the most critical stage in any investigative process.  This block of instruction will provide useful techniques allowing the investigator to maximize the interviewing process.  These techniques have been tested and employed by law enforcement agencies for decades.  Whether you are conducting a third-party witness interview or a hostile subject interview, preparing for the process is key to your success.  This instruction is taught by Stephen Quartino, retired Special Agent, United States Treasury Department 34 years on behalf of Claims Advantage, North Providence, Rhode Island.

Stephen Quartino, President of Discreet Investigative Solutions and Partner with Claim Advantage

How an Auto Insurance Carrier incorporates Crash Data into the Investigations of a Loss

Retired Mass State Police Lt. Tim Dowd, MAPFRE Accident Reconstructionist Mike Merolli, and Attorney David Brink will give a presentation on the proper use and application of the Bosch CDR Tool, other EDR tools, and new technologies that help to properly investigate auto crashes, including potentially fraudulent claims. With the advent of Autonomous vehicles, CDR Technology has begun providing additional data that reports pedestrian and collision avoidance information previously unavailable. This will be discussed as well as current legal issues regarding the access of data. A recap of the crashes conducted at the MSP EVOC facility in Ayer, MA in October 2019 will also be provided.

Attorney David Brink, Smith & Brink; Mike Merolli, Accident Reconstructionist at Mapfre Insurance; Retired Mass State Police Lt. Tim Dowd (now Senior Consultant at Rimkus)

WATER LOSSES – IS THE CLAIM FOR COVERAGE LEGITIMATE

Homeowner and Commercial General Liability policies cover sudden and accidental water damage to a home or business.  Burst pipes, frozen or otherwise, overflowing tubs, toilets, broken appliance hoses, rain from storm damages roofs or windows, are some of the claims submitted seeking coverage that may warrant in depth investigation.  Water infiltration may lead to mold claims, increasing the costs of mitigation and repairs tenfold.  Frozen pipes – did the insured use “reasonable means” to heat the home or business?  Assessing water mitigation costs, contents and inventory claims, all of which can sometimes be larger than the structural damages will be discussed.  Learn how to investigate water damage claims, preserve and prepare evidence for presentation in the defense of a claim for coverage or in a recovery action.  From first notice of loss (FNOL), investigation of the loss, assessing how the loss occurred, what damages are related, and finally a determination on whether the claim is legitimate or fraudulent will be presented and discussed. 

Attorney Jack Parenteau, Parenteau & O’Hara, PC and Attorney Barry S. Rothschild, Parenteau & O’Hara, PC

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