ASSET & FINANCIAL INVESTIGATIONS: Find me the Money: This presentation will identify the resources available in conducting asset investigations, the legal vs. illegal sources, and hidden methods of obtaining the information. This training will include the value of information obtained and the various reasons to conduct an asset or financial background check.
BACKGROUND CHECKS: Digging up Dirt: This presentation will identify the various public and private sources of information available, and how to utilize the information more effectively. The training will include several case scenarios and the best approach to take for the most optimal results. The presentation will include a discussion about the reliability of information obtained, and the most cost-effective methods of obtaining the information.
BEST PRACTICES IN WORKERS’ COMPENSATION AND LIABILITY INVESTIGATIONS: Risk Mitigation vs. Risk Tolerance: Many self-insured businesses rely upon the advice and direction of their TPA in the selection and management of their investigative vendors. However, the Risk Manager / Employer possess the decision-making power in determining who they wish to utilize as their vendors. They also possess the power to oversee the way their claims are investigated so that they can achieve maximum results and cost mitigation. This presentation will identify the best practices in conducting investigations to mitigate the risk and lower the claims costs.
COMMON METHODS OF STAGED ACCIDENT FRAUD RINGS: This presentation will identify the various staged accident schemes, the players involved, the methods of operation, and how to investigate suspected staged accidents. This presentation will include video clips of actual staged accidents caught on tape.
COMPREHENSIVE INSURED/CLAIMANT INTERVIEWS/STATEMENTS: This presentation will focus on advanced statement taking tips. We will review an actual auto theft suspected fraud recorded statement for fraud indicators, follow-up questioning, and evaluate the strengths and weaknesses of the statement taken. This presentation will also include tips on recognizing deception and evasive behavior.
DUE DILIGENCE INVESTIGATIONS: Covering Your Clients Ass-ets: This presentation will cover the merits of conducting due diligence investigations, the most useful information, and costs of obtaining it. It will include due diligence financial background checks, past history/reputation, and analyzing the findings. It will include a case study of a due diligence investigation. Submit a “due diligence” case and get a free limited investigation as part of the training.
ETHICAL AND LEGAL ISSUES SURROUNDING INVESTIGATIONS: If it’s Too Secretive, it’s Probably Too Illegal: This presentation will cover the various sources of information and their legality. The presentation will also cover the ethical issues surrounding certain investigative techniques and tactics. It will include “red flags” regarding an investigator’s sources of information, how the information is obtained, and whether it can be used in court.
EVALUATING DOCUMENTS FOR POTENTIAL FRAUD: Trust but Verify: As the first line of defense against fraud, the ability to identify red flags of fraud in documents, which are becoming increasingly more sophisticated, is very important in the claims process. This class will identify, evaluate and discuss fraud, material misrepresentation, and concealment in the form of documents that are submitted in support of various types of claims. Numerous altered and fraudulent documents submitted on prior claims will be examined and red flags discussed. There will also be a discussion on the role that current technology plays in the types of documents that are submitted and documentary evidence gathered.
FRAUD IN THE WORKPLACE: Prevention, Detection, and Investigation: Fraud in the workplace is at an all-time high and has cost many companies their reputation and financial stability. Did you know that the estimated annual business fraud loss to be about $652 billion? That the average loss in a small business is $190,000? That most fraud is perpetrated by well-educated males in senior executive positions (61%)? This presentation will identify the various methods of fraud prevention, detection, and investigation to reduce the cost of fraud in your business, and preserve the company assets, reputation, and future.
INDICATORS OF INSURANCE FRAUD (Auto, Property, Casualty, Other): This presentation will identify the various fraud indicators (red flags) of the various insurance claims. There will be discussion about how to recognize the fraud indicators at different stages of the claims process, what to do once recognized, the basics on how to investigate the suspicious claims, and fraud reporting requirements/procedures.
INVESTIGATIVE AND TECHNOLOGY SOURCES FOR THE MODERN-DAY INVESTIGATOR & ATTORNEY: This presentation will identify key databases, social media websites, identification of metadata, geotagging, license plate scanning, event data recorders, and other technology available to the Investigator and Attorney. This training will not only discuss the technological advances, but also explain beneficial uses of them for investigations and litigation
INVESTIGATING SUSPECT MEDICAL CLINICS: Fraudulent & Abusive Treatment and/or Billing: This presentation will provide training on identifying medical “mills”, fraudulent treatment and billing methods, code violations, indicators of over-utilization and treatment fraud & abuse. The training will focus on how to spot questionable medical treatment, billing and providers. The training will include discussions of actual medical records provided by the attendees that they will pre-select from their case file(s) and bring to training.
INVESTIGATING SUSPICIOUS PROPERTY/CASUALTY CLAIMS: This presentation will provide investigative strategies on how to investigate suspicious insurance claims, investigative sources and techniques utilized, laws surrounding legal investigative techniques, and discovery issues regarding the information developed.
PRIVATE INVESTIGATORS AND MEDICAL PROFESSIONALS WORKING TOGETHER TO FIGHT FRAUD IN THE WORKERS’ COMPENSATION & MEDICAL INDUSTRIES: This presentation will identify how Private Investigators are utilized in the workers’ compensation and medical industries. This training will determine what types of cases a Private Investigator can assist a medical and/or work comp professional with and also talk about the resourcefulness of Private Investigators and some of their tools of the trade.
SLIPS, TRIPS & FALLS: Fact or Friction? One of the oldest insurance scams is the slip and fall accident which has been used by individuals and organized groups for decades to rip off businesses and insurance carriers. Slip and falls are the second costliest bodily injury claim – second only to auto collisions. The presentation will discuss the most effective methods of handling suspected fraudulent slip/trip and fall accidents. The class also includes a demonstration of the latest technology to measure coefficient of friction, amazing video clips of staged slip and fall accidents and interactive case studies. This presentation will help you answer the question, fact or “friction?”
SOCIAL NETWORKING RESEARCH & INVESTIGATIONS: The Legal, Ethical and Evidentiary Issues: Social networking sites have become an exceptional tool when conducting research on individuals involved in civil litigation, criminal activity, and insurance claims. This rapidly evolving industry has also raised many issues about the legal, ethical, and evidentiary efficacy of the information obtained. This presentation will explore current issues related to past and current laws, ethics, and evolving trends that will make this a hot topic for years to come.
SURVEILLANCE: Best Practices in Utilization & Optimization: “If a picture is worth a thousand words, then a video is worth a thousand pictures.” Surveillance can be one of the most effective tools in mitigating or denying injury claims. If or when to utilize surveillance is an important consideration due to costs and results. Also, optimizing the surveillance results is an even more important consideration. So, you have great video, now what? Are you regularly getting a new medical opinion from the treating doctor, back-dating a return to work and P&S date? If not, come learn what experienced SIU Investigators can teach you to turn the video into a win on the claim file and, quite often, into an arrest.
TRIAL AND CIVIL CASE INVESTIGATION: The Difference Between Winning and Losing: This training will cover the various investigative techniques and strategies that will assist in maximizing the outcome of your case. The training will include public record sources, confidential sources, conducting surveillance (if warranted), and tracking down key witnesses/sources. There will be a discussion about the investigative strategies of the opposing side, how to combat uncooperative parties/witnesses, and investigative strategies at different stages of the case.