IASIU 2015 Program by IASIU

Table of Contents

Welcome letter from the Co-Chairs

Welcome Letter . . . . . . . . . . . . 2

IASIU 2015 is an opportunity for you to participate in top notch training from some of the best and brightest in our

Sponsors . . . . . . . . . . . . . . . . . . 2

industry, network with fellow investigators from around the world and get to meet vendors who provide innovative

IASIU Mobile App. . . . . . . . . . . 3

General Information . . . . . . 4-5

technology to help you work â&#x20AC;&#x153;smarter not harderâ&#x20AC;?. You will once again have the opportunity to support the Wounded Warrior Project at our charity golf event, and of course, we hope you will take advantage of your time in

Seminar Committee . . . . . . . . 5

Orlando to have some fun!

Hotel Map . . . . . . . . . . . . . . . . . 6

Sincerely,

Floor Plan Booth Numbers . . 7

Program . . . . . . . . . . . . . . . 8-19

Margaret Fleming, AIC, CIFI, FCLS Walter Swett, CIFI, CFE, FCLS Co-Chair Co-Chair

Meet the Candidates . . . 20-22

IASIU 2016. . . . . . . . . . . . . . . . 23

Thank you to our sponsors:

Program-At-A-Glance. . . . . . . . . . . . . . . . . . . . . . . . . .Back Cover

Primary Logo - Color

IASIU 2015 Information

at Your Fingertips!

The official IASIU 2015 mobile event guide features speaker information, session schedules and much more! Best of all, itâ&#x20AC;&#x2122;s accessible from all devices with an internet browser: Smartphones, tablets, laptops and desktops.

Wi-Fi is not needed to use the features on the mobile app in the meeting room. However, Wi-Fi is needed in order to get updates. Free Wi-Fi is available for all registrants. Be sure to refresh your device every day at the conference to ensure you have the most up to date information! HOW TO ACCESS YOUR MOBILE EVENT GUIDE:

Go to http://www.iasiu2015.mobi on your mobile browser to instantly access your mobile event guide. Your internet browser loads the event app automatically and makes it instantly available for offline use. For easier access in the future, make sure to simply add the bookmark to your phoneâ&#x20AC;&#x2122;s home screen.

SCAN TO DOWNLOAD OR VISIT THE WEBSITE WWW.IASIU2015.MOBI

Download Instructions: iPad/iPhone Devices:

1. Follow the instructions in the alert and click on the arrow icon. 2. Click Add to Home Screen. 3. Enter the text you want associated with the icon. 4. Click on the icon on your home screen to access the mobile event guide. Android Devices:

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Sponsored by: 3

General Information Exhibit Hours:

Sunday, September 13 Monday, September 14 Tuesday, September 15

Evaluations & Certificates of Attendance:

6:00 pm – 9:00 pm 7:00 am – 6:00 pm 7:00 am – 4:00 pm

Certificates of attendance are available to delegates via the online evaluation system. A link to the evaluation site will be emailed on the last day of the seminar. Media:

Registration Desk Hours:

Sunday, September 13 Monday, September 14 Tuesday, September 15 Wednesday, September 16 Registration List:

9:00 am – 6:00 pm 7:00 am – 5:00 pm 7:30 am – 4:00 pm 7:45 am – 4:00 pm

A full registration list is available via the mobile app. Please visit iasiu2015.mobi.

Members of the media may register without charge for IASIU 2015 at the registration desk by showing press credentials. Meeting Location:

JW Marriott Orlando, Grande Lakes 4040 Central Florida Parkway Orlando, Fl 32837 Photography Policy:

Photography or any other electronic recording is strictly prohibited throughout IASIU 2015. Participation in the IASIU conference constitutes an agreement by the registrant for IASIU’s use and distribution of the registrant’s images or voice in photographs, videotapes, electronic recordings and audiotapes.

Code of Ethics:

By attending IASIU 2015, you agree to adhere to the IASIU Code of Ethics. Visit iasiu.org/about/code-of-ethics. Wireless Internet/ Wifi:

Password: Investigation

Spouse/Guest:

If you require special arrangements in order to fully participate in IASIU 2015, please speak with an IASIU staff member at the registration desk.

Spouse/Guest registration includes the Sunday Welcome Reception, Monday’s Opening Ceremony & Awards and Wednesday’s Closing Reception. Spouse/Guest registration excludes: vendor reception, breakfasts, luncheons, breaks and expo. Spouses/Guests do not receive commemorative shirts.

Antitrust Statement

Disclaimer:

Special Needs Accessibility:

Members of this organization -- and participants in this meeting -must be mindful of the constraints of the antitrust laws. There shall be no discussion, nor any agreements or concerted actions that may restrain competition. This prohibition includes the exchange of information concerning any of the following: individual company rates, coverages, market practices, claims settlement practices, or any other competitive aspect of an individual company’s operation. Each member or participant is obligated to immediately speak up to prevent any discussion of this type or that is outside these bounds. Badges:

Attendees must wear the IASIU 2015 seminar issued name badge at all times. Badge Checkers:

Opinions expressed at IASIU 2015 are not necessarily those of IASIU, its officers, directors or members and should not be construed as legal advice or a recommendation of conformity.

IASIU 2015 Seminar Committee: Committee Chairs:

Margaret Fleming, AIC, CIFI, FCLS, IASIU Director Walter Swett, CIFI, CFE, FCLS, IASIU Director Committee Members:

Approved CE Credits:

Rebecca Gonzalez William Howells, CIFI, FCLS Kevin Keating Brett Kelley, FCLS, South Florida IASIU Chapter President Kim Kuster, CIFI, CIFA, FCLS Ian Oliver, FCLS, ACLS Anthony Parker Mary Sadousky, CIFI Ellen Withers, CIFI, AIC, AIM, SCLA, IASIU Secretary

Presentations:

Administration:

At various events, including the expo hall and food functions, there will be badge checkers. Attendees will be turned away if no badge is visible. Visit the IASIU registration desk to obtain a badge. Workshops:

Attendees may attend any workshop without informing the IASIU registration desk.

Information on approved CE’s in Florida can be obtained at the registration desk. All sessions qualify for CIFI/CIFA/CIFR credit hours.

All presentations have been posted on the IASIU website and are accessible for download, subject to permission by presenter. Drink Tickets:

Attendees receive five (5) drink tickets. These may be used at any of the three (3) receptions; welcome, vendor and closing. Shirt Tickets:

Attendees who submitted their shirt size during registration prior to August 15th, receive a shirt ticket at registration. Redeem the ticket for your commemorative shirt at the table as you enter into the exhibit hall. There are no exchanges and shirts not picked up will not be mailed.

IASIU Executive Office N83 W13410 Leon Road Menomonee Falls, WI 53051 P: (414) 375-2992 F: (414) 359-1671 Email: info@iasiu.org Executive Office Staff:

Bill Elliott, Executive Director Tracy Kaschak, Meetings Manager Haley Montsma, Marketing and Membership Coordinator

Hotel Map

IASIU 2015 Exhibit Floor Plan

For full exhibitor and sponsor information visit: iasiu2015.mobi

102.................... Rimkus Consulting Group 104.................... Veracity Research Co. 106.................... Contego Services Group 107.................... Marshall Investigative Group 108.................... GlobalOptions 109.................... Social Discovery Corp 110.................... American Educational Institute, Inc. 111.................... Combined Investigators 111B.................. Maya & Maya Inc. 112.................... SIU Central Inc 113.................... Wynyard (USA) Corp. 114.................... Maryland Claims Investigation, Inc. 115.................... Kevin B. Hays Fire Consulting, LLC 116.................... Woodall & Broome Investigative Services 117.................... laims Verification Inc 201.................... ISG 202/301/403... LexisNexis 203................... G4S Compliance & Investigations 204................... DRN 205................... TransUnion 206................... The Robison Group

207................... Mexico Investigations 208................... IAAI 209................... INTERTEL INC 210.................... DONAN 211.................... INFORM 212.................... North American Training Group 213.................... Lemieux & Associates 214.................... Enservio 215.................... ARRCA 216/315............ BAE Systems Applied Intelligence 302/401........... ISO Claims Solutions 303................... Hub Enterprises 304................... U.S. Forensic 305................... Red Mountain Technologies 306................... Search Pros, Inc 307................... Bonnamy & Associates, L.L.C. 308................... Ethos Risk Services 309................... PATCtech 310.................... Crash Data Group 311.................... Armstrong Forensic Laboratory 312.................... Becker and Company Investigations

313.................... Auto Data Direct 314.................... Benoit Language Services, Inc. 316.................... ICS Merrill 400................... MasterTrace 402................... Polonious Case Management Systems 404................... Advantage Surveillance, Inc. 405................... SAS 406................... Kelley Alliance 407................... Delta Associated Investigations Inc. 408................... RRC â&#x20AC;? Asia 409................... Leckinger Investigations 410.................... LTAS Technologies Inc. 411.................... Accident Support Services International Ltd. 412.................... Blue Eagle Investigations 413.................... ICmaritime, LLC 414.................... Merge Investigations, Inc. 415.................... National Insurance Crime Bureau 416.................... Thomson Reuters Foyer..................Utica College

Sunday, September 13, 2015

12:30 pm – 3:00 pm CIFI Registration and Exam

6:00 pm – 9:00 pm Insurance Fraud Expo

Amarante 2-3

Coquina North

2:30 pm – 6:00 pm CIFA Registration and Exam

6:30 pm – 8:30 pm Welcome Reception

Amarante 2-3

Coquina North

Monday, September 14, 2015 Conference Begins 7:00 am – 6:00 pm Insurance Fraud Expo

Coquina North

7:00 am – 8:00 am Breakfast with Exhibitors

Coquina North

Opening Ceremony/General Session

Mediterranean Ballroom 5-8

8:00 am – 8:15 am:

Wade Wickre, CIFI, FCLA, IASIU President, will kick off IASIU 2015 with an update on IASIU initiatives over the past year, provide a membership update and share the organization’s goals and accomplishments with the members.

8:15 am – 8:30 am:

Joe Wehrle, National Insurance Crime Bureau (NICB), President and CEO, will provide members with an update on NICB activities.

8:30 am – 8:45 am:

Dennis Jay, Coalition Against Insurance Fraud, Executive Director, will inform members on upcoming initiatives to advance its mission and further the efforts on fighting insurance fraud.

8:45 am – 9:05 am:

Simon Blank, Florida Division of Insurance Fraud, Director, will speak on current trends, pending or potential legislation that could impact the fight against insurance fraud as well as the impact of recent PIP reforms.

9:05 am - 9:35 am: Wounded Warriors Presentation

The 21st Annual IASIU Golf Tournament is proud to make a charitable donation to the Wounded Warriors project. Hear from Jason Brasse, a veteran who has gone from the brink of suicide to almost complete recovery.

10:10 am – 10:30 am Break

Coquina North

10:30 am – 12:00 pm:

Keynote Presentation by Brad Montgomery 9:35 am - 10:10 am:

IASIU 2015 Awards Ceremony Investigator of the Year Award

Recipient must be the primary or lead investigator who completed the majority of the investigative tasks that proved the fraud. One or more significant events of the investigation must have occurred during the year of the award. Significant events are defined as the majority of investigative activities, indictments/criminal charges being filed or civil actions. Analyst of the Year Award

Recipient must be in good standing of IASIU, both during the investigation and at the time of the award. One or more significant events of the investigation must have occurred during the year of the award. Significant events are defined as the analysis that initiated the investigation, majority of analytical/investigative activities, indictments/criminal charges filed or civil actions. Award year runs from previous July to July of current year. Public Service Award

IASIU’s Public Service Award recognizes NICB, Law Enforcement, Prosecutors, and representatives from Public Agencies and/or organizations. Outstanding Service Award

After graduating from Brown University with a degree in Political Science, Brad immediately became a comedian and magician. (His parents were a tad worried) But, it all worked out well. He started his career doing magic and comedy, moved to comedy clubs, then cruise ships and larger corporate events. He now speaks to corporate, association and government groups about levity, lightheartedness and how having a sense of humor helps increase the bottom line at work; how happiness at work helps us excel. He’s mighty proud of his credentials and accomplishments, but to be honest, he’s most proud of his family: an awesome wife and three awesome kids. Occasionally, they even laugh at his jokes. Insurance fraud is a serious billion dollar business impacting millions of Americans. SIU’s are the frontline defense against these attacks. With so much at stake on a daily basis, this custom keynote presentation will focus on staying positive during periods of change and finding that perfect work/life balance. Brad Montgomery is a powerful orator who has made millions laugh with his award-winning, inspiring and very funny Laugh-O-Nomics. 12:00 pm – 1:00 pm Lunch

Coquina North/South

IASIU’s Outstanding Service Award recognizes contributions to the insurance industry, an individual’s company, the community and the association. Nominees may be anyone who has made a substantial contribution to insurance anti-fraud efforts.

1:15 pm - 2:45 pm

2015 Multi–Jurisdictional Investigative Excellence Award

Level Rating: Intermediate/Advanced Location: Mediterranean 8

IASIU’s Multi–Jurisdictional Investigative Excellence Award recognizes the work of a cooperative investigative effort of agencies, carriers, organization or task forces. SIU Today Appreciation Award

In recognition of those who have gone above and beyond to deliver solid content to IASIU’s official publication.

Congratulations to this year’s recipients!

Concurrent Sessions Storm and Roofing Fraud Claims: Small Claims Equal Big Dollars

Through real world examples, you will learn about common fraud schemes that occur after storms, primarily related to roofing claims. You will learn how to spot fraudulent claims and how to handle them efficiently. The topic will include various issues relating to fraud, overreaching on the claims and how appraisal is used to perpetuate fraud claims. Tony Krall, Attorney, Hanson Lulic & Krall, LLC Chapter Presidents Meeting

Location: Mediterranean 7 9

Monday, September 14, 2015 continued

The 3 M’s of Property Fraud: Marring, Matching & Misrepresentation

2:45 pm – 3:00 pm Break

Coquina North

Level Rating: Intermediate/Advanced Location: Mediterranean 6

Troublesome claims arise where diminutive damage can result in incongruent and ridiculously large indemnity awards. In the past, it would be unusual for an insured to file a claim for such seemingly small damage, however, today increased consumerism, public adjuster retention and liberal risk policies have helped fuel an exponential increase in these claims and insurers are footing the bill. The rise of these claims has insurance fraud investigators on alert. This presentation will discuss how marring, matching and misrepresentation issues are central to litigating such claims and how interpretation of policy language is the key to their successful defense. James Cole, Shareholder, Chair, Fraud/SIU and Property Litigation Practice Groups, Marshall Dennehey Warner Coleman & Goggin Hillary Dean, Managing Counsel, P&C Legal, Nationwide

Looking Backward to Look Forward: Using Historical Analysis to Drive Future Investigations

Level Rating: Intermediate/Advanced Location: Amarante 2-3

This presentation will cover basic strategies for identifying suspicious billing patterns, discuss the larger context of historical analysis, both its advantages and limitations, focus on fraud networks and in-depth research and analysis techniques to identify inherent weaknesses to exploit, focused primarily on medical billing. The combination of these factors will create opportunities where the accumulated knowledge base combined with unique reporting tools can identify suspicious claims early in their life cycle in a targeted and streamlined approach. Matthew Allatin, Intelligence Analyst, Travelers Insurance Company Nichole Matthews, Medical Fraud Investigator, Travelers Insurance Company

Chiropractic/Medical Fraud: Are we Fighting the Last War?

Level Rating: Intermediate/Advanced Location: Marbella 1-2

This course will address the historical evolution of Provider Fraud in bodily injury claims and the SIU current challenges to avoid “Fighting the Last War.” David Kassabian, Attorney, Kassabian, Doyle & Weatherfor, PC

3:00 pm – 4:30 pm

Concurrent Sessions Oh No...Not Another RICO Presentation

Level Rating: Intermediate/Advanced Location: Mediterranean 8

Over the past 10 years, insurance company Special Investigation Units have dedicated increasing resources to the detection of organized fraud rings and the prosecution of civil affirmative recovery actions. In many of these actions, insurance company plaintiffs have included (RICO) causes of action. Geared toward insurance company SIU Analysts and Major Case Investigators rather than attorneys, this workshop will emphasize the practical over the theoretical, it will focus upon RICO court opinions issued in 2013–2014. The program will endeavor to demonstrate how the RICO Statute is evolving as an increasingly powerful tool in the fight against insurance fraud. Using real world case studies, the program will explore how the inclusion of RICO counts impacts the resolution of individual cases. This workshop will also highlight some of the novel and commonly annoying defenses and counterclaims that are proffered by defendants, particularly in medical provider fraud cases. By analyzing the claims and defenses being put forward in recent reported cases, insurers will be in a better position to anticipate and defend against such averments. David Brink, Litigation Manager, Smith & Brink, PC

Introduction to the 2015 NICB Member Benefit Report Roundtable: New Format, New Data, Greater Member Value

Level Rating: Basic Location: Mediterranean 7

The 2014 NICB Member Benefit Report Committee Chair, John Sargent, along with other Committee members will review and highlight the upcoming changes to the format and data captured in the revised 2015 NICB Member Benefit Report (MBR). Panelists will provide examples of how they use the data on the current report within their own organizations, as well as outline how they believe the new format and additional data points will provide increased value moving forward. John Sargent, SIU Director, MetLife Auto & Home Group-Moderator Steve Jarrett, SIU Director, Westfield Group Brian Smidt, Vice President, Data Analytics, National Insurance Crime Bureau

Auto Body Repair Fraud

Level Rating: Intermediate/Advanced Location: Mediterranean 6

4:30 pm – 6:00 pm Vendor Reception

The session will focus on identifying the various forms of body shop fraud, how they are performed and video snippets of some common schemes. The session will discuss various forms of fraud as well as discuss case studies that depict some forms of fraud and ways to identify them.

Coquina North

James Solorio, Strategic Case Investigator, Travelers Insurance Bill Hearrold, Regional Manager, Travelers Insurance

Online Investigation of e-Commerce, Classifieds and Social Media

Level Rating: Intermediate/Advanced Location: Amarante 2-3

Bring fraud threats into focus faster.

The speaker presents hands-on technical tips and tricks for how to extract necessary information, utilize free and low-cost open source data online, familiarize the audience with what can and cannot be searched easily on websites such as Craigslist, eBay, Facebook, etc. Allen Atamer, CEO, LTAS Technologies Inc.

The Whole Nine Yards: Preliminary Investigations

SPE C I AL T R ACK

Level Rating: Intermediate/Advanced Location: Marbella 1-2

Analytics

Now investigators have the power to spot potential threats quicker. SAS® Fraud Framework can detect highly sophisticated fraud schemes sooner by uncovering hidden relationships and seemingly unrelated events. Powerful analytic techniques quickly identify and prioritize cases to investigate. Our multifaceted approach provides more accurate data by combining information from existing resources. It protects your data in a secure, flexible environment.

Learn more

Pre-registration not required

During this presentation, you will be taken through a real case investigation that starts with a simple referral on a single claim file and grows into a major case, revealing over 1 million dollars in exposure. This multi-faceted investigation touches upon many different investigative techniques and avenues, each of which are investigations unto themselves. The various investigations are then tied together by a number of common threads that are discovered using the latest modern investigative technology. By combining the findings in these individual investigations, the case as a whole becomes strengthened. This investigation encounters and demonstrates many different fraudulent activities such as staged accidents, enhanced damages, medical billing fraud, policy application fraud and even possibly bank fraud, all of which are illustrated. It combines tried and proven street investigative techniques such as interviews, EUOs, material damage, investigations involving enhanced vehicle damages, investigations of medical tests and treatments and medical clinic inspections. It leverages the use of new technologies available for use in investigations which can be very revealing, such as social networks, link analyses and computer tracking/identification through their IP addresses and cookies. Various litigation strategies are then weighed to determine the best way to defend claim denials. These include the discussion of the pros and cons regarding proactive (DJ action) of combined claims vs reactive individual suit defenses. The goal is to leave individuals with new ideas that can be used in investigations.

sas.com/security

IASIU 2015 MOBILE APP The official IASIU 2015mobile event guide features speaker information, session schedules and much more! Best of all, it’s accessible from all devices with an internet browser: Smartphones, tablets, laptops and desktops. http://www.iasiu2015.mobi or Scan to Download

Sponsored by:

Transportation to Downtown Disney

Tuesday, September 15th

Buses depart from main entrance at the top of the hour.

Pick up

AT JW MARRIOTT - MAIN ENTRANCE:

Drop off

AT LOT Q/SHUTTLE BACK TO JW MARRIOTT:

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10:30 pm - LAST SHUTTLE

Wednesday, September 16, 2015 Insurance Carriers Obligation to Protect Evidence

Level Rating: Intermediate/Advanced Location: Mediterranean 6 7:15 am – 8:15 am Breakfast

Coquina South

8:15 am – 9:45 am

Concurrent Sessions Affirmative Litigation Issues - Are You Prepared?

Level Rating: Specialized Location: Mediterranean 8

More carriers are bringing affirmative litigation cases as part of their arsenal in the fight against insurance fraud. However, affirmative litigation cases present a wide array of novel issues not seen in the normal course of defending a lawsuit. This session will address many of those issues, including what are carriers required to produce in civil discovery, claims manuals and bill review software, what tactics do the defendants use to defeat affirmative cases and dissuade carriers from bringing future actions, what issues are presented by parallel law enforcement activity, who is a proper defendant, how do you build an affirmative case and what legal options exist and how do you enforce settlement agreements. Dennis Kass, Partner, Manning & Kass Richard Garcia, Partner, Manning & Kass Laura McAdams, Attorney, Manning & Kass An Insurer’s Dilemma: Investigating Rideshare Claims and its Effect on Personal Auto Policies

Level Rating: Intermediate/Advanced Location: Mediterranean 7

Every day it seems that a new livery type service utilizing personal vehicles pops up with an available app on your smart phone offering transportation services. These new business ventures raise a myriad of issues for insurers regarding first party claims submitted by your policyholders and their passengers and/or third party claims submitted by others against your insured’s policies. Personal injury and property damage claimants are seeking compensation for coverages that may or may not be afforded under either personal or commercial policies. The claims may be legitimate and/or fraudulent. The uncertainty raised by these new complex coverage issues, when combined with the inconsistent ways insurers are handling these claims can give rise to an increased potential for the submission fraudulent/exaggerated claims against several different insurers simultaneously. Learn about how courts across the nation are dealing with these new issues, explore the different ways an insurer might proactively attempt to limit its exposure in relation to these claims and discuss the development of strategies for handling these claims in the future. Audrey Parr, Attorney, Parr Law, PC Corrine Taylor, Litigation Paralegal, Parr law, PC 16

This presentation will discuss and illustrate many of the common, yet improper evidence collection and storage practices utilized by professionals who in the normal course of conducting their business collect, document and store evidence, on behalf of insurance clients. We will discuss modern collection and storage techniques, tracking technology, management methods and other approaches that insurers, investigators, attorneys, adjusters and anyone that handles evidence should consider. Joseph Toscano, Senior Investigator, Jack Ward Fire Consultants Guy Burnette, Attorney, Guy E. Burnette, Jr. P.A. Peter Vitale, SIU Manager, Homesite Insurance Provider FWA: Real World Revelations

Level Rating: Basic Location: Amarante 2-3

Recent estimates have put fraud, waste and abuse by medical providers in property and casualty insurance at $30 billion annually. In this session, we will first discuss the three specific ways to help combat these rapidly rising medical costs. Real world, operational stories and data will be presented from 1-2 top 20 US insurers, highlighting the approach, steps taken and the results. Ken Cunningham, Vice President, Claims Analytics, LexisNexis Risk Solutions John Lorimer, VP of Analytics and Product Management, LexisNexis Risk Solutions

Moving Targets: How the Bad Guys Adapt and What to do About it

Level Rating: Intermediate/Advanced Location: Marbella 1-2

This presentation will focus on what we have learned in recent years in our fight against medical provider fraud. We will illustrate examples of how unscrupulous medical providers have adapted their scams based on our successes in uncovering them. Topics will include a discussion of a new Edx image alteration scheme and how recent CPT code changes are being leveraged to maximize billings. Other medical treatment areas such as MRI and drug screening will also be explored. We will then provide strategies on how to identify and prove medical provider fraud, including how to work with law enforcement to obtain valuable knowledge through seized computers and best practices in conducting EUOs and depositions. Lori Smith, President/CEO, Pattern Analysis, Inc. Randalla Braddom, Medical Expert, Pattern Analysis, Inc.

9:45 am – 10:15 am Break

Outside of session rooms

10:15 am – 11:45 am

Concurrent Sessions Avoiding Defamation Liability: The Lessons of State Farm v. Radcliff

Level Rating: Basic Location: Mediterranean 8

The Indiana case of State Farm v. Radcliff resulted in an affirmed award of $14.5 million for State Farm SIU’s alleged defamation of a roofing contractor, one of the largest defamation awards in United States history. Overlaid with the facts and verdict of the Radcliff case, this presentation will explore the legal elements of and defenses to defamation claims and outline strategies for avoiding defamation liability when investigating losses and claims suspected to be fraudulent. Roy Mura, Managing Member, Mura & Storm, PLLC

New Vehicle Technologies and How to Use Them to Decipher Actual Theft from Fraud

Level Rating: Intermediate/Advanced Location: Mediterranean 7

Today’s vehicles contain 23-80 microcomputers, devices which retain valuable information about what recently happened around the vehicle. The objective of this discussion is to examine some features and capabilities in General Motors’ products which may provide valuable clues when investigating cases. Several new cutting edge security technologies will be discussed along with various cases that show the value of the process, knowledge of the technology and the evidence left behind in vehicle systems. There will also be a discussion of the “Magic Box that unlocks all car doors” and a discussion of factual research and examination of evidence as to its substantiation. William Biondo, Global Vehicle Security Lead, General Motors

Using Big Data to Fight Insurance Fraud

Level Rating: Intermediate/Advanced Location: Mediterranean 6

More data promotes better decision making for claims adjusters. The key to combating fraud is combining a large industry claims database across all lines of business with third-party data combined with using predictive analytics to detect fraud in its early stages of development. The ultimate objective is to embed predictive analytics in the first notice of loss (FNOL) process and shut down fraud quickly before it escalates and impacts your bottom line. New predictive analytics tools can cut claim lifecycles, as the adjusters with the right skill sets would receive appropriate claims sooner and with fewer handoffs along the way. Ultimately, claims departments would be able to significantly improve SIU referral quality and customer service, both through speed and fairness. In this session, a technology expert will present industry best practices for combating fraud with big data and predictive analytics. Buzz Hirt, Director, Professional Services & Development, ISO Claims Solutions

Separate, But Equal...Understanding and Maximizing the Relationship Between the Department of Financial Services and Insurance Companies

Level Rating: Intermediate/Advanced Location: Amarante 2-3

This session will discuss current and past relationships between DFS and insurance companies. Included in the discussion will be how to maximize that relationship in order to provide DFS with the best opportunity for solid arrests, prosecutions and how to work alongside insurance companies and their counsel to obtain optimal resolution of their investigations and/or civil recovery actions. Frank Goldstein, Managing Partner, Goldstein Law Group Steve Smith, Captain, Department of Financial Services Howard Pohl, Attorney, Department of Financial Services Building the Fraud Recovery Case From Investigation Through Trial

Level Rating: Intermediate/Advanced Location: Marbella 1-2

Presentation will analyze a RICO/Fraud damage recovery suit from investigation, to suit filing and through trial. David Kassabian, Attorney, Kassabian, Doyle & Weatherford, P.C. Joe Rocha, Sr. SIU Field Analyst, Allstate Insurance Company 11:45 am – 1:00 pm Lunch

Coquina South

1:15 pm – 2:45 pm

Concurrent Sessions Twelve Huge Cases in Twelve Short Months! (An Overview of the Most Significant Insurance Fraud Decisions from around the United States in 2013 and 2014)

Level Rating: Basic Location: Mediterranean 8

As SIU professionals continue to battle evolving insurance fraud schemes and conspiracies, they must, at the same time, monitor the new cases and legal trends impacting the detection and prosecution of SIU matters. It is vitally important to keep abreast of new decisions as significant cases are receiving widespread and immediate internet publicity. In this session, attendees will be introduced to a dozen newly decided cases from both state and federal courts, including, California, New York, Florida, New Jersey, Michigan, Maryland and others. Case topics will include: admissibility of statistical evidence, medical expert qualification, spoliation of evidence, RICO pattern cases and proof of referral networks. The presentation will include an analysis as to how these decisions are influencing the SIU legal landscape, as well as the tactics and strategies insurers should employ to investigate suspicious claims and/or develop successful major case recovery actions. David Brink, Litigation Manager, Smith & Brink, P.C. 17

Wednesday, September 16, 2015 continued Current Schemes in Healthcare Fraud: Durable Medical Equipment and Narcotics Diversion

Level Rating: Intermediate/Advanced Location: Marbella 1-2 Vehicle Fire Analysis–Stolen–Burned–Fraud

Level Rating: Intermediate/Advanced Location: Mediterranean 7

This course is designed to evaluate the methodology in determining the origin and cause of a vehicle fire based on the manner in which the fire is initiated, method of fire progression and an understanding that it is dependent on complex, interdependent phenomena that includes the physics of combustion, heat transfer and fire spread. Then based upon the observations and findings from the inspection, interviews and other information gained determine whether the vehicle fire cause was an accidental or incendiary. T. David Harlow, Fire Investigator, TDH Investigation

Aggressive Contractors and Problematic Property Claims

Level Rating: Intermediate/Advanced Location: Mediterranean 6

This session will explore the unique circumstances surrounding severe storms and storm chasers, indicators to look for, common schemes associated with storm chasers and case study examples of fraudulent behavior.

This session will focus on Kaiser Permanente’s advanced efforts in the areas of durable medical equipment and narcotics. As the payer and the provider, advanced analytics and investigative techniques, including the use of social media, along with the findings and outcomes of the many cases pursued. Durable Medical Equipment (DME) and supplies are a known area for fraud and theft along with being high on Medicare’s list. While we have unearthed numerous cases through advanced analytics, this presentation will focus on three specific high value cases and take the audience from discovery to adjudication of each case. Along with DME, narcotics diversion and abuse is a rampant epidemic. Our investigations surface activity that feeds advanced analytics. We will share the beginning to end process of three cases that emphasize the investigative approach and the use of data and how the investigative techniques also impact quality of care and patient safety. Jay Loden, Asst. Director, Data Analytics, Kaiser Permanente Tamara Neiman, Director, National Special Investigations, Kaiser Permanente 2:45 pm – 3:00 pm Break

Outside of Session Rooms

3:00 pm – 4:30 pm

Concurrent Sessions

David Moss, Asst. Director HO Claims, Liberty Mutual

Ethics for the Investigator, Walking the Line

Level Rating: Specialized Location: Mediterranean 8

Using EDR Data to Confirm Fraud

This presentation will outline both the rights of the investigator and the source of those rights in the insurance policy and in the law. It will then outline the limitations which must be understood in connection with those rights, which derive from ethical responsibilities imposed by the IASIU code of ethics and statutory and case law which circumscribe the investigator’s actions.

Level Rating: Specialized Location: Amarante 2-3

The first portion of this session will identify damage caused to vehicles that were unrelated to subject accidents and how the damage can be determined. Additionally, the evaluation of airbags that were made to look like a deployment occurred, identifying tool marks on the cover, evaluating the airbag itself and the data contained in the vehicles EDR will be presented. The second portion presents an overview of commercial vehicle event data recorders (EDRs) and discusses the volatility of their data, with particular reference to the evidence preservation process. Specific recommendations regarding evidence preservation are discussed, and a case study is presented illustrating a commercial vehicle EDR download that led to an evidence spoliation claim. Shannon Haddox, Senior Forensic Analyst, EFI Global

Wendelyn Walberg, Managing Member, Walberg Allan, PLLC Doug Osborne, SIU Large Loss Manager, Kemper Insurance Services Vehicle Fraud After a Catastrophe

Level Rating: Intermediate/Advanced Location: Mediterranean 7

Following a major natural catastrophe, thousands of vehicles are declared damaged or missing. Almost immediately, these vehicles, or vehicles bearing their identification numbers, begin to appear throughout the country. Many of these vehicles bear no indication that they were previously salvage/flood vehicles and are sold to innocent purchasers or are used in fraudulent claims. This session explores the multitude of opportunities for vehicle fraud that surface following a catastrophe, how the chaos following these events often cause the vehicle issues to be lost in the shuffle and investigative resources and techniques that can be used to stem the tide. Steve Bodge, SIU Major Case Manager, Nationwide Insurance Tomi Dorris, SIU Director, Nationwide Insurance

Metadata and Google Images

Level Rating: Basic Location: Mediterranean 6

Google Images can be utilized to reverse search photographs provided by insureds/claimants as proof of ownership for stolen items. Google Images reverse search will identify if the photograph was taken off the internet. The presentation will also focus on metadata of photographs and identifying the dates the photographs were created to determine if the photographs were taken before or after a loss incident and possibly confirming the gps location where the photographs were taken. The presentation will also cover the limitation of utilizing metadata and the reason for a strong recorded interview with the insured in order to determine if fraud has occurred. The subject of referrals to Department of Insurance and prosecution will be discussed as well. Thomas Malatino, Special Investigator, Citizens Property Insurance Corporation Charles Beall, Special Investigator, Citizens Property Insurance Corporation

Shell Companies and Hidden Payroll: What to Look for and How to Investigate

Level Rating: Intermediate/Advanced Location: Amarante 2-3

This course is designed to provide the attendee information relative to the identification and investigation of the most prevalent form of Workers’ Compensation Insurance Premium Fraud, the use of shell companies and non-traditional money service businesses or check cashing stores, to funnel construction industry payroll, undetected to cash paid labor. The attendee will receive an overview of how this scheme is created and works. Historically, it has evolved into several forms which can make detection difficult. Practical examples of criminal cases investigated will provide an inside look at the complexities of this organized criminal behavior, allow the attendee to understand the scope and magnitude of the problem as well as the serious threat it poses to the Workers’ Compensation market in the State of Florida. Through the use of actual documents and materials identified and used during criminal prosecutions, as well as summaries of admission and confessions of some of the individuals who operated some of these criminal enterprises, the attendee will have a hands on and interactive learning experience with the instructors, both of whom have spent much of their careers working on the prevention, detection and prosecution of workers’ compensation premium fraud. The course will provide the attendee with the unique perspectives gained during the course of both criminal and SIU/civil investigations into the shell company phenomenon and large scale premium avoidance schemes.

Medical Fraud: The Detection and Defense of Unreasonable Medical Care Focusing Upon the Injection of Medication into the Spine and Surrounding Structures

Level Rating: Intermediate/Advanced Location: Marbella 1-2

The use of epidural steroid injections by anesthesiologists and other providers identifying themselves as pain management specialists creates a difficult challenge for insurers in the defense of first and third party claims. We will present an in depth analysis of billing codes applicable to all medical providers/procedures involved in billing by physicians doing the injections, preinjection radiologists who review the diagnostic tests that supposedly justify injections, the imaging centers performing the diagnostic tests, the bill from surgical centers where injections are performed and the anesthesiologist who administers the anesthetic pre-injection. Review a case study in which Ms. Kelly and the undersigned defended the insurance company and its insured in a combined tort and UIM claim in a binding high-low arbitration. This defense resulted in a savings to the carrier in excess of $100,000. A PowerPoint presentation will set forth the relevant CPT Codes along with examples of the incorrect billing codes used by each of the above mentioned health providers. Finally, there will be handouts of hypothetical examples of billing practices and CPT Codes that the class attendees can work through to gain a greater understanding of the issues involved. Paul Festenstein, Atttorney at Law and Partner, Condon & Cook LLC Danelle Kelly, President, D. J. Kelly & Associates 6:00 pm – 9:00 pm Closing Reception

Mediterranean 5 Porte Cochere

Geoffrey Branch, Senior Investigator, Swiss Re America Holding Corporation Deborah Martin, Attorney, Deborah S. Martin, PLLC & Galvin Messick, LP

Meet the Candidates Wade Wickre, CIFI, FCLA IASIU President

President:

For the My name is Wade Wickre, and I’m running for re-election as President of IASIU. a firm developed IASIU time, this During past two years, I have served as IASIU President. come. to years for success for ion organizat our positions foundation that certainly The IASIU created an Organizational Improvement Committee in September 2013. on, informati that From ion. organizat our about on informati for committee asked members to support the board developed a Strategic Action Plan and began working on new ideas insurance IASIU. Our intent is to build IASIU into an even stronger global organization of is to assist focus Our . members our is attention of center board’s The ors. investigat fraud , each member achieve personal developmental goals through meaningful education our board, the on working by ties opportuni leadership and ons certificati industry-recognized committees and with our chapters around the world. We leverage IASIU is the largest organization of insurance fraud investigators in the world. the our position through legislative initiatives and partnerships with our strategic partners, with tool legislative a rs co-sponso IASIU Fraud. Insurance NICB and the Coalition Against s notes the Coalition called “engage” that allows members the opportunity to send legislator states. their supporting insurance fraud legislation in of members Our chapters have grown with the addition of the North Carolina Chapter. A group the Board June, in and state that in chapter in South Carolina petitioned the board to start a from areas received been have on informati for requests other Several approved their petition. of the world interested in starting new chapters. with one of IASIU celebrated its 30 year anniversary last year in Greensboro, North Carolina our progress the largest seminars in some years. Members and the board are excited about members not and the future of IASIU. Our board is progressive and is a working board where The board es. committe our on work and leadership provide but matters board handle only meetings other at and industry the in ideals and represent s IASIU and promotes our mission and events. an advisor As President of IASIU, I serve as an advisor to NICB’s Board of Governors and as as election my to Prior e. Committe Executive Fraud’s Insurance to the Coalition Against my duties President, I served as IASIU’s Vice President and Chapter Chair for four years where on a regional included working with chapter president s and leaders, helping them build IASIU basis. , I worked I joined Nationwide’s SIU in 1991 after leaving law enforcement. Shortly afterward 1998, Vice – 1996 from Treasurer their as serving Chapter IASIU Virginia the with closely In President in 2001, President from 2002 to 2004 and Director from 2004 – 2006. of its member a as Division Fraud Insurance Police State Virginia the with Virginia, I worked nal Internatio the served I Board. Theft Advisory Board and served on the Help Eliminate Auto – 1994 from n chairperso its as and 1995 – 1993 from e IASIU on the Awards Committe 1995. .I Today I am the SIU Director for the Southeast United States at Nationwide Insurance can tackle realize that IASIU is an integral partner in fighting insurance fraud. None of us to leverage insurance fraud alone. Together with our industry partners, IASIU is in a position significantly help to insurance of nts departme and ent enforcem law with along ips partnersh reduce the occurrence of fraud. fraud Our members need cutting edge anti-fraud education to stay abreast of insurance g fully educated trends. Our CIFI and CIFA designations are the industry standard for recognizin Insurance insurance fraud investigators. Our Certifications Committee developed the Certified individuals Fraud Representative, CIFR designation designed for claims representatives or wanting to become an insurance fraud investigator. hip and IASIU has taken strides in the past several years to deliver value to its members reputation in IASIU’s nally. internatio growing are increase our presence around the world. We by working IASIU support to you ask I . members our to strength added provides the industry who others with ips partnersh build to on committees, volunteering to lead our chapters and combat insurance fraud. e your vote I’m committed to leading our organization into the future. I ask for and appreciat . for re-election as IASIU President

Adam Featherling, CIFI, CFE

Vice President:

s of members of International Association of Special Investigation Units is made up of thousand background and diverse a from come members The world. the around s companie the insurance hip. members the of spirit during my 10 years as a member I have seen the as the National Currently, I head the Special Investigations Unit of the Kemper Services Group need to SIU Director. With a previous background in law enforcement, I recognize the ongoing fraud collaborate with local, state, and federal agencies to be successful and promote CFE. education and training, acquiring such designations myself that include CIFI and If designated, my goals would be to: • Expand volunteer opportunities for our members through • Expand training opportunities for members by working with our chapters and learning online • Collaborate with organizations with a common fraud fighting interest • Open communication with members to improve the organization we are • Review and possibly update the long term strategy of the association to ensure Mission consistent with the IASIU of IASIU and I believe that I meet the unique qualifications for the position of Vice President of Treasurer positions The member. a as and board the have learned a lot during my time on association and the of success the drive that details the see to me allowed Chair Seminar and ion with other my role as a National Director allow me to discuss the importance of the organizat national leaders. to serve you and Thank you for your consideration. I look forward to the prospect of continuing this organization.

Vice President: Mike Skiba for the I am Mike Skiba and I am seeking a position on the IASIU Board as Vice President nd can two-year term starting in September 2015. I believe that my experience and backgrou in operating career 20-year a enjoyed have I ion. organizat IASIU benefit the members of the and analytical various capacities in the SIU environment; claims, investigator, management, roles all round out my diverse fraud career. President I was elected Vice President of the New York Chapter of IASIU in 2008, and then 200% over grew hip members our Chapter, NY in 2009. During my six year term leading the multiple creating state; the with ty communi anti-fraud the in leader the and we became IASIU has led partnerships with law enforcement, state agency, and private firms. New York our industry. We in legislation g supportin in active extremely is and s many anti-fraud campaign campaigns. have a dedicated legislative liaison on our board that serves to spearhead these e. I obtained Besides my chapter experience, I believe that I offer IASIU my academic perspectiv I have been an an MBA in 2002 and then a PhD with an emphasis on economic crime in 2013. State University adjunct professor for over ten years and am currently lead faculty at Colorado network can academic nal internatio my that believe I program. ent managem fraud in their assist with IASIU development and growth. column and I I am a regular contributor to the SIU Today magazine with my The Doctor Is In industry fraud insurance many for am also active in researching, presenting, and publishing ty. communi IASIU the of benefit the for set skill this utilizing to forward look organizations. I groups industry of dozens to exposed Through my academic and professional work I have been ion. within our industry and truly believe that IASIU is the premier fraud fighting organizat and fraud fight y effectivel to Networking and training are two of the most important aspects fronts. these of IASIU is definitely the leader on both appreciate I am extremely motivated to secure a seat on the IASIU board and would greatly . your support and vote for IASIU’s Vice President

Board & Officer Election Information: Voting will take place on Tuesday, September 15th at the IASIU Business Meeting from 4:00 pm - 5:00 pm in Mediterranean 8.

All companies represented by regular members receive one vote per group as defined by AM Best. Designated group representatives are encouraged to pre-register at the IASIU Registration Desk.

Secretary: Cathy Gicker, CIFI, FCLA

Good Day, everyone! I hope you all enjoy this IASIU Seminar, the training and the fabulous networking. This is an exciting year! My name is Cathy Gicker and I have had the privilege of being an IASIU member since 1991. Because of YOUR support and MY dedication and passion for IASIU, I have been honored and fortunate to serve in several board positions over the years. I was VP and then President of the Delaware Valley In Chapter for 5 years total. I then sought and won a BOD position for the International for 2 years. I . Committees Chapters and Seminar the chairing years 6 for served and VP as 2003, I was elected have attended every Seminar since 2000. I also have my CIFI and FCLS designations. In 2010, I was honored to be the recipient of the IASIU Outstanding Service Award. I am an IASIU Lifetime member. For this year’s voting, I am again looking AND hoping for your support to elect me as the IASIU Secretary. My MAIN campaign slogan is COMMUNIC ATION FOR ALL!! To me, the BOD is tasked with SERVICE to our members and to be held ACCOUNTABLE for executing the vision and mission of the organization. We need to be more conversant with our members so they can feel included in the organization and take pride in its accomplishments and direction. If I am elected as the Secretary and Editorial Chair, I would produce an excellent magazine/enews publication with a variety of topics to showcase the successes of our members and chapters, including the most topical and cutting-edge articles to enhance your SIU knowledge and invite our members to be active in submitting Letters to the Editor to continue to improve towards excellence. I would suggest we continue with the staple articles which educate our members on legislation and compliance. This is YOUR magazine and with the number of members we have nationally and globally, there is certainly enough to make the communication vehicles interesting, innovative and inclusive. I would also compose a subcommittee of chapter presidents and members to help with the execution of top notch publications with the focus on having our members be recognized for their outstanding contributions to defeating fraud. I would encourage more chapter activity and ensure there is representation for all. Our members are OUR greatest resource and I would seek out participation from our members to work WITH me to move forward to be the best organization in the SIU industry. I am also a major proponent of keeping our members updated with BOD activity affecting us and current trends in the SIU world. This could be accomplished via a consistent publication calendar for both the SIU Today and the SIU e-News AND to periodically send global e-mails to our members on crucial IASIU business. I will be an advocate for changes that improve value for our members and I will take ownership to ensure the BOD makes decisions in the best light for the membership at large. My platform will to keep the lines of communication WIDE open so YOU, our members, feel YOUR importance is at high value to IASIU.

Can I count on YOUR vote to be your IASIU Secretary? For those of you who know me, I am tireless, a dedicated and willing/able to be YOUR advocate on the BOD for the next 2 years. I know I can do Orlando! in you See vote! your good job for YOU and the BOD so I hope you will give me THANKS for your consideration and I would LOVE to be your Secretary! Cathy

John D. Kloc, FCLS

Treasurer:

My name is John Kloc and I am running for a second term as IASIU Treasurer. I am on the Awards Committee and also serve as Chair of the Constitution and Bylaws committee. It has been a distinct pleasure to have been on the Board during a period of transition. Both the new management company, Acumen and the IASIU Board have accomplished a great deal. Financial reports are vastly improved and on-line access to accounts allows timely assessment of our financial position. IASIU’s “Operating Fund and Reserve Policy“ was updated to more efficiently balance our cash accounts and investments. In addition, we worked with our investment advisor Benefit Watch, LLC to review our portfolio and assure that in the future, holdings will be actively managed. This allows for adjustment to market conditions as needed, however, trading fees and commissions have been capped at a pre-determined rate so that risk can be managed at minimal cost. Finally, a small change in the Constitution and Bylaws has allowed the International to assist in Chapter dues collection if a Chapter so desires. As a result of excellent attendance at our annual seminar last year in Greensboro and continuing fiscal diligence, IASIU is financially sound and well positioned to grow its ability to undertake projects that promote education for our members and allow the organization to have greater influence in global anti-fraud efforts. I am truly excited about IASIU’s progress and if elected, I pledge my very best effort to help IASIU attain its organizational goals. I would respectfully ask for your vote in September.

Ellen Withers, CIFI, AIC, AIM, SCLA

Secretary:

Thank you for the honor of allowing me to be a member of the board of IASIU. I ask your continued support to serve one more term as Secretary. I have filled the post of editor of SIU Today magazine since my election to the board and currently chair the Editorial Committee and serve on the Seminar and Organizational Improvement Committees. It has been an enriching and rewarding experience to work with the officers and directors of our international board. This hard work has forged a strong relationship with NICB and the Coalition Against Insurance Fraud in our fight against insurance fraud. The board has also provided an unsurpassed fraud fighting education and networking experience through our annual training seminar and CIFI program. We also strive to improve education and communication through SIU Today magazine and eNews. As an international organization, we are united by our ability to communicate insurance fraud related issues. We must continue to improve our relationship with members from all over the world and information must be available how you want it, where you want it, and when you want it. This is why I chose to work as chair of the Education Committee. I have worked in insurance claims for twenty-six years, twenty-one of those years with State Farm Mutual Automobile Insurance Company©. I’ve been a member of their Special Investigation Unit for nineteen of those years. During an additional term, I would like to continue my work to improve our publications, while keeping our focus on providing comprehensive educational information to our members. Thank you for your consideration. Ellen Withers, CIFI, SCLA, AIC, AIM, AIS Claim Specialist, Multi-Claim Investigation Unit © State Farm Mutual Automobile Insurance Company

Dallas Barnes, FCLA IASIU Director

Director:

Director: Lou Larose, CIFI

My name is Dallas Barnes and I am running for a second term on the IASIU Board of Directors. I have had the honor of serving on the board for the last two years, and am proud of what our organization has accomplished. I have had the pleasure of serving on numerous committees and have chaired the following committees: Nominations Committee, Membership Committee, and the Communication Task Force. I believe my active participation has contributed to the success and growth of our organization. I have worked in insurance claims and SIU for over 24 years, and I am currently the National Division Manager of the Special Investigations Unit for Farmers Insurance. Farmers’ SIU has afforded me the opportunity to oversee the expansion of our SIU department; creation of a medical investigation specialty unit; Predictive modeling software integration; technology integration; and affirmative fraud litigation. If you honor me with your support, my primary goals for the organization would be: • Collaboration with fraud fighting organizations • Promoting public awareness • Providing innovative training to combat insurance fraud • Supporting and strengthening our local chapters If elected, I will utilize all my resources to strengthen and grow IASIU.

I am a founding member of the New England Chapter of IASIU where I served as president for several years. I have also chaired the New England Seminar Committee and we recently celebrated our 10th year. Thank you for your consideration.

Jim McClary, CIFI, CFE

Director:

My name is Jim McClary and I am looking for your vote to be one of your IASIU directors. I am the SIU Field Supervisor with Safe Auto Insurance, serving in this capacity since 2009. I have been with Safe Auto Insurance SIU since 2005. Prior to joining Safe Auto, I was a homicide detective at the Columbus Ohio Division of Police.

Thank you for your consideration.

Director: Kim Kuster, CIFI, CIFA, FCLS

I am seeking your support for election to the IASIU Board of Directors. Over the past 17 years, I have held various positions within SIU, ranging from investigative assistant to desk investigator to forensic data analyst. I am currently a Manager in the SIU department at Grange Mutual Casualty Company located in Columbus, Ohio. I am responsible for the analysts within the Intelligence Unit as well as some of our field investigators. I am currently serving as the President of the Ohio Chapter of IASIU and have been in this position for the past three years. Prior to being elected President, I served on the board of the chapter. I have enjoyed working with the members who represent carriers that are diverse in size and nature of their book of business. I strive to support the mission of IASIU at the local level and promote a coordinated effort between carriers and law enforcement to combat fraud and provide high caliber education and training events across the state. This past year I was a member of the 2015 Seminar Planning Committee and assisted in developing the multi-session track focusing on major case investigations. Since 2010, I have served on the national Certification Committee. I have assisted this committee on various projects including the development of the analyst certification exam and its most recent revision, the European Chapter’s CIFI exam as well as partnering with NICTA to launch a CIFI preparatory course. I proctor both exams in my area and frequently answer questions from members interested in testing. I take great pride in assisting with the development of the designations that IASIU offers as they are highly respected in the SIU community. I believe the IASIU organization should be represented by a diverse group of individuals who represent the membership and the various roles that now make up the SIU industry, specifically the analyst role. If nominated to the board, I would bring my many years of service in the industry and represent a unique perspective with my understanding of SIU field as well as the analyst role. I am passionate about our profession and would be honored to receive your support. I am committed to represent you, the membership. I will work hard to ensure that the organization expands its influence both at a state and national level, remains dedicated to combating current issues facing the industry and delivers innovative training. 22

I am a candidate for a seat on the IASIU Board of Directors. I’m asking for your support as I strive to balance the board and ensure that the perspective of an investigator is always present and brought forward in every issue the board addresses. This is an organization that was founded to advance the career and professionalism of investigators. I want to be that voice. For the past 17 years I have been employed by Amica Mutual Insurance Company as a senior investigator in their SIU. Prior to that, I was a police officer in Massachusetts, retiring as a sergeant.

At Safe Auto, I have been instrumental in the building of the Special Investigations Unit. I developed Safe Auto’s SIU Fraudbuster program and provide annual fraud instruction to Sales and Customer Service departments. Additionally, I provide newly hired claim personnel with introductory fraud training. I have been a member of IASIU since 2005. I am a Certified Insurance Fraud Investigator, Certified Fraud Examiner. I also have obtained the insurance industry designation of SCLA, FCLA, and AIC. I was President of the Ohio Chapter of IASIU from 2008-2012. If I am elected, I will strive to have the board do a better job reaching out to the membership and finding out what they really want from their organization. If elected to the board of directors, I will work to ensure that our membership is seeing the benefit of being a member of IASIU. There was a time in this industry that SIU only had to mention the word fraud and their bosses opened the checkbook. Those days are over. If elected, I will see that the board will give our membership the most bang for their buck. That starts with providing quality and meaningful training. I will ensure that our membership has a reason to stay active in the organization. If elected, I will ensure the board continues to evaluate and critique the training after the conference ends. In any training, the goal is to take something away that you can use. If the training doesn’t provide what members need, then they will go away dissatisfied. I will strive to make sure the training needs of the entire membership are met. The face of SIU is changing. The typical investigator today is more technology savvy and I will work to see that the board changes with the industry and offers more emerging technology training courses at the IASIU seminar. Another area that I will work to improve is providing more support for the local chapters. As the past president of the Ohio Chapter, I know the difficulties in building and maintaining a strong membership base. I also know the issues involved in a local chapter trying to organize and fund training events. I believe that our organization is only as strong as our local chapters. It is mutually beneficial that the board provide support when requested by a local chapter. The board has a wealth of experience that would be invaluable to our local chapters. I’ll use the Texas South Chapter as a great example of a local chapter that promotes fraud awareness throughout Texas and actively keeps their membership involved in the chapter. If elected to the board of directors, I will work to continue and increase IASIU’s fraud awareness campaign throughout the industry. For those who deal with multiple states and multiple jurisdictions, you know the difficulties of trying to get an insurance fraud investigation investigated or prosecuted. I would work with IASIU to encourage legislators around the country to increase funding for insurance fraud prosecutions or funding to support insurance fraud investigative units. I would appreciate your support as I seek a position on the IASIU Board of Directors.

2016

September 11-14, 2016 Las Vegas, Nevada • Red Rock

Fraud…a losing bet 23

Program-At-A-Glance Tuesday, July 14 Sunday, Sept 13

Monday, Sept 14

Tuesday, Sept 15

Wednesday, Sept 16

12:30 pm – 3:00 pm

7:00 am – 6:00 pm

7:00 am – 4:00 pm

7:15 am – 8:15 am

Amarante 2-3

Coquina North

CIFI Registration and Exam

Insurance Fraud Expo

Breakfast

Coquina South

2:30 pm – 6:00 pm

7:00 am – 8:00 am

8:15 am – 9:45am

Amarante 2-3

Coquina North

CIFA Registration and Exam

Breakfast with Exhibitors

6:00 pm – 6:45 pm

8:00 am – 9:35 am

Coquina North

Mediterranean Ballroom 5-8

Insurance Fraud Expo

Opening Ceremony/General Session

6:30 pm – 8:30 pm

9:35 am – 10:10 am

Coquina North

Mediterranean Ballroom 5-8

Welcome Reception

Breakfast with Exhibitors

Affirmative Litigation Issues - Are You Prepared?

Coquina North

Mediterranean 8

8:00 am – 9:30 am

An Insurer’s Dilemma: Investigating Rideshare Claims and its Effect on Personal Auto Policies

Emerging Trends in the Investigation of Insurance Claims

Mediterranean 8

IASIU 2015 Awards Ceremony

Craigslist Vehicle Finance Fraud Investigation

10:10 am – 10:30 am

Break

The Cyber Crime Underground and Its Impact on Insurance Claims and Investigations

10:30 am – 12:00 pm

Origin and Cause of Ethics

Keynote Presentation by Brad Montgomery Mediterranean Ballroom 5-8

12:00 pm - 1:00 pm

Lunch Coquina North/South

1:15 pm – 2:45 pm

Storm and Roofing Fraud Claims: Small Claims Equal Big Dollars Mediterranean 8

Chapter Presidents Meeting

Mediterranean 7

Mediterranean 6

Marbella 1-2

Amarante 2-3

Moving Targets: How the Bad Guys Adapt and What to do About it Marbella 1-2

10:15 am – 11:45 am

Marbella 1-2

9:30 am – 10:15 pm

Break

10:15 am – 11:45 am

Senior Management Roundtable Mediterranean 8

Role of Social Media in a Fire Loss Investigation and Subsequent Litigation

Chiropractic/Medical Fraud: Are we Fighting the Last War?

Provider FWA: Real World Revelations

The Whole Nine Yards: Analysis- Beyond the Red Flags

The 3 M’s of Property Fraud: Marring, Matching & Misrepresentation

Amarante 2-3

Mediterranean 6

9:45 am – 10:15 am

Gone in 60 Seconds: The Age of Electronic Thievery

Looking Backward to Look Forward: Using Historical Analysis to Drive Future Investigations

Insurance Carriers Obligation to Protect Evidence

Amarante 2-3

Mediterranean 7

Mediterranean 6

Mediterranean 7

Mediterranean 6

Best Practices for Operationalizing Fraud Analytics Amarante 2-3

The Whole Nine Yards: The Medical Fraud Marbella 1-2

11:45 am – 1:00 pm

Lunch/Vendor Raffle

Break

Avoiding Defamation Liability: The Lessons of State Farm v. Radcliff Mediterranean 8

New Vehicle Technologies and How to Use Them to Decipher Actual Theft from Fraud Mediterranean 7

Using Big Data to Fight Insurance Fraud Mediterranean 6

Separate, But Equal...Understanding and Maximizing the Relationship Between the Department of Financial Services and Insurance Companies Amarante 2-3

Building the Fraud Recovery Case From Investigation Through Trial Marbella 1-2

11:45 pm – 1:00 pm

Lunch Coquina South

1:15 pm – 2:45 pm

Coquina North/South

Twelve Huge Cases in Twelve Short Months!

Break

1:15 pm – 3:15 pm

Vehicle Fire Analysis–Stolen–Burned–Fraud

3:00 pm – 4:30 pm

Mediterranean 8

2:45 pm – 3:00 pm

Oh No...Not Another RICO Presentation

Social Media Research 201: Beyond the Basics

Mediterranean 8

Auto Body Repair Fraud

Introduction to the 2015 NICB Member Benefit Report Roundtable: New Format, New Data, Greater Member Value

On The Record: The Value of Cell Phone Records in Suspicious Claims Investigations

Mediterranean 7

Auto Body Repair Fraud Mediterranean 6

Online Investigation of e-Commerce, Classifieds and Social Media Amarante 2-3

The Whole Nine Yards: Preliminary Investigations Marbella 1-2

4:30 pm – 6:00 pm

Vendor Reception Coquina North

Mediterranean 7

Mediterranean 6

ICD-10 - Implications for Fraud-2015 Update Amarante 2-3

The Whole Nine Yards: The Pre-Litigation & Litigation of SIU Claims Marbella 1-2

4:00 pm – 5:00 pm

IASIU Business Meeting Mediterranean 8

5:15 pm – 6:15 pm

Sponsor Meetings

Mediterranean 8 Mediterranean 7

Aggressive Contractors and Problematic Property Claims Mediterranean 6

Using EDR Data to Confirm Fraud Amarante 2-3

Current Schemes in Healthcare Fraud: Durable Medical Equipment and Narcotics Diversion Marbella 1-2

2:45 pm – 3:00 pm

Break

3:00 pm – 4:30 pm

Ethics for the Investigator, Walking the Line Mediterranean 8

Vehicle Fraud After a Catastrophe Mediterranean 7

Metadata and Google Images Mediterranean 6

Lexis Nexis-Amarante 2-3 ISO ClaimSearch-Marbella 1-2

Shell Companies and Hidden Payroll: What to Look for and How to Investigate.

6:00 pm – 11:00 pm

Medical Fraud: The Detection and Defense of Unreasonable Medical Care: Injection of Medication into the Spine

Shuttle to Downtown Disney Main Lobby