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2017 Educational Sessions

Contents Claims: Hard Fraud/Soft Fraud

Session Code:  0525    Session Level:  Intermediate

Curriculum: Special Investigations/Fraud

Tuesday 3:30 - 5:00 -- Room 311
Wednesday 1:30 - 3:00 -- Room 203

Greg Nelsen,
Consultant, Tarpon Springs, FL

Andy Rock, JD,  Attorney
The Rock Law Group, Maitland, FL

  • Compare hard fraud, which involves complete fabrication, with soft fraud, which involves inflation
  • Identify and implement the most effective means of detecting fraud
  • Initiate and utilize new tools for dealing with fraud
  • Implement effective defenses based on fraud, concealment, and misrepresentation

Pill Mill Operations: Detecting & Investigating

Session Code:  0545    Session Level:  Intermediate

Curriculum: Special Investigations/Fraud

Monday 3:30 - 4:30 -- Room 204
Wednesday 8:30 - 9:30 -- Room 107

Steven A. Bodge, SCLA, CFE,  Major Case Manager
Nationwide Group, Washington, WV

Tomi L. Dorris, CFE, CIFI,  SIU Director-Midwest
Nationwide Group, Columbus, OH

  • Identify the scope of the problem caused by the overprescribing and abuse of prescription narcotics
  • Trace the connection between pill mills/drug diversion and insurance fraud
  • Identify various drug diversion schemes used by both claimants and providers
  • Recognize investigative techniques and methods to reduce losses attributed to drug diversion

SIU Investigations: Emerging Trends

Session Code:  0565    Session Level:  Intermediate

Curriculum: Special Investigations/Fraud

Monday 3:30 - 5:00 -- Room 302
Wednesday 8:30 - 10:00 -- Room 207

Scott Gleitz, CPCU, CIFI, AIC,  Dir.-Special Investigations
North Star Mutual Insurance, Cottonwood, MN

Nicholas J. Maxwell, JD,  Partner
Maschka, Riedy & Ries, Mankato, MN

  • Identify data recorded and stored by today’s “smart” devices
  • Evaluate the use of that data in SIU investigations
  • Recognize emerging methods to generate falsified documents
  • Contrast legitimate documents with “fakes”
    ** Recognize how “Appraisal” is being used to commit fraud and increase insurer’s liability