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October 27, 2021
Operation Backlash was one of the biggest workers compensation fraud cases in recent history. This case uncovered a massive scheme to cheat the California workers’ compensation system out of hundreds of millions of dollars. The sheer scale of this case is staggering, involving doctors, attorneys, marketers – nearly 40 individuals and corporations. NICB is pleased to welcome the lead deputy district attorney from Operation Backlash to provide insight and details into this major prosecution.
San Diego County District Attorney
Perception and Negotiations in Comp Claims
Haste makes waste, or sometimes with workers’ compensation claims, claim decisions made in haste can be quite costly. Learn how a subtle change in your perspective might help you determine if a claim is compensable or if it could be mitigated in some way. Having the strategic edge with these valuable negotiation techniques will set your claims resolution experience apart from the rest. This fun and interactive session will show you the benefits of thinking outside the box, and how sometimes a seemingly individual claim will point to an organized fraud ring.
Best Practices and Tips When Testifying
You worked diligently on your claim investigation and you’ve developed a case that will be tried in court. Now what do you do? This session will provide you with a roadmap to courtroom testimony. Veteran insurance fraud prosecutor Shaddi Kamiabipour will provide tips and best practices to follow when you are asked to testify in court.
Orange County District Attorney
I Know What You Did Last Summer – and Probably the Summer Before
We know that social media has become a treasure trove of information that might prove useful in your workers’ compensation claim investigations. We also know that fighting fraud is no laughing matter. Fighting fraud is serious business, but Michael Petrie will keep you grinning as he provides his unique perspective and information you can use as you conduct social media searches in support of your comp investigations.
Workers' Compensation Motor Vehicle Accidents
Some carriers have seen an increase in workers’ compensation claims involving motor vehicle accidents. You might have experience working auto related claims in your career, but maybe it’s been a while. How might you frame your investigation into a work comp claim where the injured worker was driving a commercial vehicle? Learn some of the questions and strategies that might help you determine compensability in work comp cases that are also auto related.
October 28, 2021
Telemedicine Driven Claims
Telemedicine has exploded over recent years and, with it, so have fraudulent telemedicine driven claims. Presenter Jeffrey Rapattoni describes this as “The Wild West”. He will provide insight into the regulation and history of these claims, as well as discuss ways in which insurers might be exploited and how to investigate these claims.
Panel Discussion: SIU Hits & Misses
If I only knew then what I know now… We’ve gathered an impressive lineup of industry experts to ask them to share the lessons they’ve learned through the years as the workers’ compensation fraud landscape has evolved.
Moderated by Terri DiGiorgio
Data Analytics in Support of Criminal Investigations
In this session, using real criminal case scenarios and readily available software, such as Excel, Power BI, and Google Earth, we will learn how the data is located and received, how the data is organized, and how the data is used to support criminal investigations. Techniques will include finding data points in various sources, converting PDFs to tables, locating and exporting tables from websites, formulas, pivot tables, visualization options, and the use of dashboards for analysis.
Collision Data Retrieval
Event data recorders, or black boxes, are now standard in most newer vehicles. This session provides an overview of EDR parameters, data retrieval process and the opportunities for collision data engagement. Collision data retrieval can be another important tool in your fraud-fighting arsenal. This session will provide valuable information that will help you delve further into motor vehicle related workers’ compensation claims.
Identifying and Investigating Premium Fraud
Premium fraud has a huge financial impact on the insurance industry. Staggering amounts of money are lost when companies are not paying accurate premiums. This session will provide an overview of premium fraud and its impact on the underground economy; as well as fraud indicators that will help you identify and investigate premium fraud, along with tips on obtaining a successful prosecution.