INTRODUCTION:

Insurance fraud and abuse is a serious problem costing consumers several millions of dollars every year. An abundance of studies supports this statement. A 1996 study estimates that fraud cost the insurance industry $120 billion in 1995, including the health care and life sectors. The health care sector alone accounted for 80% of the total, or $95 billion. Fraud in the Property & Casualty sector in the same year was estimated at $20 billion. By 1999, the Property & Casualty industry estimated $24 billion. And in Life & disability, insurance fraud totaled $5 billion. The opportunities and quick cash in insurance fraud and abuse have spawned a multi-billion dollar industry where lawyers, doctors, employers, common criminals, and otherwise honest citizens profit from their skills in deception through the criminal acts of insurance fraud and abuse. In late 1999, the Government Accounting Office (GAO) released a study of the Medicare, Medicaid and private insurance sectors which confirmed that organized crime is heavily involved in health care fraud.

To combat the onslaught of insurance fraud, insurance companies formed Special Investigative Units, Departments of Insurance created Fraud Bureaus, federal agencies created Fraud Control Units, and state and federal law enforcement agencies created investigative units to combat fraud and abuse. Auto theft units were also created in most large police departments in cities with high rates of auto theft where they are finding citizens committing insurance fraud through dumping of vehicles for profit. In the private sector many companies were formed to provide assistance to insurance companies with field investigations, surveillance, research, consulting, legal services, and other antifraud measures in general. Here again, a multi-billion dollar industry was spawned, this time to combat fraud and abuse.

PROGRAM OBJECTIVES:

 This five day "Insurance Fraud & Abuse" program endeavors to educate this second group of dedicated individuals who have chosen to combat insurance fraud and abuse. This course is not an end to antifraud education, but a beginning that will prepare attendees to not only understand the contract of insurance, but also prepare them to meet the needs of their chosen profession by understanding the differing insurance fraud schemes and investigative techniques required to defeat them

Police and quasi-police investigators are generally considered a reactive approach to crime deterrence. This program will present opportunities to utilize this expertise proactively to prevent fraud before it occurs. Methods to introduce the investigators expertise in the underwriting, marketing, information systems, training, legal, and claims departments of insurance companies will also be discussed.

Continuing education is the key to success. This forty hour course will help you define your career goals and send you on your way to achieve them.

PURPOSE:

The purpose of the "Insurance Fraud & Abuse"  program is to train attendees to ensure that they can apply a standard level of adequate and timely Life Safety and Industrial Security, Policies and Procedures within Insurance Fraud & Abuse environments.

Upon completion, a Mounted Certificate is awarded in "Insurance Fraud & Abuse".

WHO SHOULD ATTEND:

All those whose responsibilities include the Detection, Deterrence, Prevention, Investigation, and Prosecution of Insurance Fraud and Abuse or the development and deployment of antifraud programs will benefit from this program. Special Investigations Units Investigators, Lawyers, Senior Adjusters, Fraud Bureau Investigators, Federal, State or Local Law Enforcement Investigators, and Private Investigators are all candidates for this course.

CONTINUING EDUCATION UNITS (CEU):

Continuing Education Units (CEUs) are nationally recognized units in qualified programs which allow the participant to document all non credited work completed. CEUs may be used as evidence of increased performance capabilities and for job advancement, and are recognized by many professional organizations and companies.

CERTIFIED PROTECTION PROFESSIONAL (CPP) RECERTIFICATION:

Documentation of attendance at these programs may be submitted to the ASIS Professional Certification Board for consideration of recertification credit by qualified Certified Protection Professionals.

PRINCIPAL INSTRUCTORS:

G. F. Bryant Jr.;  is a member of the Electronic Crime Task Force with the Miami Division of the U. S. Secret Service.  He is an internationally recognized Physical, Operational and Technical Security Analyst, Contingency Planner and Educator with more than twenty five years of combined experience in physical & operational security, and investigation technologies. He founded Bryant & Associates to provide threat assessment, risk analysis and systems integration after serving several years as the primary technician for a governmental law enforcement agency. He teaches and consults internationally on state-of-the-art equipment, techniques, and operational procedures to managers, technicians and other security & loss prevention professionals in both government and private industry that include numerous Fortune 500 companies. The originator and developer of extensive technical, operational and managerial security & life safety programs at the university level, Mr. Bryant is active in the design, application, installation and field maintenance of Integrated Facilities Protection Systems utilizing the Total Facilities Management approach. He is a frequent speaker at international conferences and exhibitions and his articles regularly appear in various security industry publications. Mr. Bryant is an active contributor to new product development projects for many international manufactures.

Mr. Bryant served as Chairman of a Chapter of the American Society for Industrial Security (ASIS).  He is a member of the South East Florida Chapter of the Association of Contingency Planners (ACP) and the National Defense Industrial Association (NDIA). He has also been a member of the Armed Forces Communications & Electronics Association (AFCEA), The Academy of Security Educators & Trainers (ASET), the Fire Educators & Technology Section of the National Fire Protection Association (NFPA) and served on Committee F-12 on Security Systems & Equipment of the American Society for Test & Material (ASTM). Mr. Bryant contributed to a monthly column on Systems Integration in Access Control & Security Systems Integration magazine and was the Technical Editor of International Corporate Security, a magazine published in the United Kingdom. He has been appointed to the advisory boards of Defense & Security Electronics, CCTV Applications & Technology, Access Control & Security Systems Integration, Security Technology & Design and Southeast Asia Fire & Security magazines.

Mario C. Martinez; M.B.A., CFE, CIFI;  is an internationally recognized Consultant in Telecommunication Security with a Master of Business Administration in International Marketing. Mr. Martinez is the Director of Administration at the World Institute for Security Enhancement and retired as Director of Security for Southern Bell Telephone and Telegraph Company directing all corporate security operations in the southern district of Florida. During his career he participated in a number of law enforcement task forces in Florida and Washington D.C. to enhance telecommunications technologies available for criminal investigations. During his tenure with Southern Bell he attended numerous management, technical, telecommunication, and investigative security courses. He has also developed and presented numerous programs in the areas of computer security and investigation.

Mr. Martinez has represented Bell System's business interests in the United States, Canada, and Spain. He was assigned to review security measures at Compania Telefonica Nacional de Espana (Telefonica) following terrorist bombing attacks directed at telephone company facilities in Madrid. He was later assigned to review telephone facilities security measures in Barcelona, Spain in connection with the 1992 Olympic Games in Barcelona. He has been cleared "Top Secret" by the Department of Defense and the Federal Bureau of Investigation.

Mr. Martinez is an active member of numerous associations including the American Society for Industrial Security (ASIS). He is a Certified Fraud Examiner (CFE) from the Association of Certified Fraud Examiners and a Certified Insurance Fraud Investigator (CIFI) from the International Association of Special Investigation Units.

Insurance Fraud & Abuse

PROGRAM OUTLINE:

                      IFA-01    The Contract of Insurance

                      IFA-02    Insurance Laws

                      IFA-03    Unfair Claims Practice

                      IFA-04    Ethics

                      IFA-05    Anti Fraud Plans

                      IFA-06    Fraud Control Strategies

                      IFA-07    Developing and Deploying a Fraud Control Program

                      IFA-08    Introduction to Insurance Fraud & Abuse

                      IFA-09    Federal & State Fraud Statutes

                      IFA-10    Legislative Mandates for Anti Fraud Plans and Indemnity Laws

                      IFA-11    Property & Casualty Fraud & Abuse

                      IFA-12    Healthcare Fraud & Abuse

                      IFA-13    Workers Compensation Fraud & Abuse

                      IFA-14    Life Insurance Fraud & Abuse

                      IFA-15    Investigative Techniques

                      IFA-16    Surveillance Techniques

                      IFA-17    Interviewing Techniques

                      IFA-18    Statement Techniques

                      IFA-19    Examination Under Oath and Depositions

                      IFA-20    Investigative Resources and the Internet

                      IFA-21    Report Writing Techniques

                      IFA-22    Special Investigative Units, Fraud Bureaus, Law Enforcement,

                                      & Investigative Agencies Liaisons.

COURSE SCHEDULE:

The above timetable approximates the schedule for this course.

Instructors may choose to vary the program and any changes will be announced.

General Information:

 Click here for the registration form for this class: