2014 - Compliance WithThe Insurers' Requirement to Investigate and Defeat Fraud

Instructor: Barry Zalma
Description:
This webinar provides the training required by California and other states for the annual training of integral anti-fraud personnel. It highlights the recognition of the indicators or red flags of insurance fraud; referral of insurance fraud investigations to the special Fraud Investigation Unit (SIU); and the basic investigation of a potentially fraudulent insurance claim.
In "Compliance With The Insurers' Requirement to Investigate and Defeat Fraud" Barry Zalma will highlight the materials in his E-Book, "California SIU Regulations" to help insurers and their integral anti-fraud personnel to comply with the SIU Regulations and avoid the fines imposed by Departments of Insurance for failure to comply.
Insurance fraud is a multi-billion dollar business that, rather than being prosecuted by state police agencies, are required to be prosecuted by the victim insurers. To properly fulfill the obligation imposed on insurers by state law, it is necessary to train the insurer's personnel to recognize possible fraud, investigate the fraud and defeat fraudulent claims. It also will assist the insurer in preparing a thorough investigation that can be presented to the appropriate police agency for prosecution as a crime.
Why Should you Attend:
Insurance company integral anti-fraud personnel defined as: ""Integral anti-fraud personnel" includes insurer personnel who the insurer has not identified as being directly assigned to its SIU but whose duties may include the processing, investigating, or litigation pertaining to payment or denial of a claim or application for adjudication or claim or application for insurance. The personnel may include claims handlers, underwriters, policy handlers, call center staff within the claims or policy function, legal staff, and other insurer employee classifications that perform similar duties." (Emphasis added.) [California SIU Regulations, Section 2698.30 (k).] This includes almost every employee and officer of an insurance company.
"Compliance With The Insurers' Requirement to Investigate and Defeat Fraud" highlights the evolution of SIU investigations and the training needed for integral anti-fraud personnel to present potential fraud investigations to the SIU.
Objectives of the Presentation:
The Webinar is designed to implement California Code of Regulations, § 2698, and regulations from states across the United States with similar statutes and regulations.
Definition of insurance fraud.
The elements of insurance fraud.
The purpose of an SIU.
Case studies of insurance fraud investigations.
Various types of insurance fraud.
The red flags of fraud.
How to recognize fraudulent documents.
Who can Benefit:
Insurance adjusters whether employed by insurer or acting as an independent insurance adjuster.
All claims staff personnel from clerks to management.
Insurance claims managers.
Insurance claims supervisors.
Insurance coverage lawyers.
SIU investigators.
Insurance defense counsel.
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Online Compliance Panel LLC.
38868 Salmon Ter, Fremont
California 94536, USA
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