Fraud Management Professionals Explore the Latest Strategies for Combating Insurance Fraud at 2009 IFM Conference

By Thomas Mulvey

For three days in March, more than 300 professionals gathered in Orlando, Florida, for the annual Insurance Fraud Management Conference to discuss the latest trends and tactics in the management of insurance fraud prevention, detection, investigation, and prosecution efforts.

The conference, sponsored by ISO and the National Insurance Crime Bureau, brought together more than 300 key decision makers in the insurance fraud-management field.

That group of professionals represents the SIU management ranks of more than 50 property/casualty insurance companies, the National Insurance Crime Bureau (NICB), state fraud bureaus, and more than 40 product and service providers that are key to the industry’s antifraud efforts.

The tone for the conference was set at a gathering on the first morning with remarks from three prominent industry leaders.

ISO Senior Vice President Vincent Cialdella welcomes attendees to the conference.	Thomas Mulvey, national director of SIU and Claim Services at ISO, addresses conference attendees

Vincent Cialdella, a senior vice president at ISO, welcomed the conference attendees and congratulated them on their efforts in fighting insurance fraud over the past year, noting some of the challenges brought about by the current economic strain.

“It’s time to rethink what we do and how we do it,” he said. “This is a time to consider new data solutions, innovative products, procedure alterations, process streamlining, and improved risk management. Your imagination as a decision maker will play a vital role as you plan to meet the challenges of a tough economy.”

Joseph Wehrle Jr., president and chief executive officer of the National Insurance Crime Bureau, outlined the efforts of his organization, explaining that there are five disciplines integrated into the NICB operation: data analysis, investigations, training, legislative advocacy, and public awareness. The work of the NICB is vital in the industry’s effort to fight insurance fraud and to assist in prosecuting the culprits.

Joe commented that renewed efforts are needed in the significant areas of information sharing, proactive investigations, public awareness, and innovation. In closing, he noted that “insurance fraud is crippling the economy, and each one of us has a shared responsibility to win this conflict.”

Doreen Spadorcia, executive vice president of Claim Services for Travelers Insurance, shared her thoughts on insurance fraud resistance in the face of the economic downturn. Doreen outlined some areas of positive development over the last several years, noting that in the fight against fraud, the industry is “more cohesive and aligned, data has been elevated to a strategic priority, and there has been a move to work with a broader group of industries and thinkers leading to more innovation.”

“The challenge now,” according to Doreen, “is the industry must stay the course in its commitment to fight fraud while under extreme expense pressure.” She added, “It’s quite clear the economy is down, but I’m not so sure that the unemployment rate for criminals is going to go up.”

The exchange of ideas continued through 16 concurrent workshops covering some of the most significant issues facing the SIU segment of the insurance world (see sidebar). Several nationally recognized experts participated in those discussions.

Two additional general sessions on the second and third days of the conference were well received. Kirk Nahra, a partner with the Washington, D.C., firm of Wiley Rein, is an expert many in the industry turn to in the specialized area of privacy. Kirk spoke about the latest trends, requirements, and interpretations regarding information sharing, data security, and privacy regulation compliance. Kirk very effectively outlined areas of concern and described accepted practices to eliminate risk.

Dr. Rick Wakefield, J.D., D.C., P.A., president and chief executive officer of International Healthcare Consultants, shared his thoughts on how to create a productive environment for medical investigations. His unique perspective — illuminated by his doctorates in chiropractic medicine and law — and his lively presentation provided insight on how to manage those complex investigations.

The products and services expo at the conference offered attendees the opportunity to meet with representatives from the companies that provide vital assistance in the areas of antifraud technology, investigative assistance, public information data sources, forensics, and educational offerings. Attendees also had the opportunity to network and learn how their peers are integrating new techniques and technologies into antifraud operations.

The closing session of the conference was a panel discussion with managing directors from seven state insurance fraud bureaus and the National Association of Insurance Commissioners. The panel members discussed insurance fraud trends in their jurisdictions, relating anecdotes of fraudulent behavior resulting from the economic downturn. Panel members discussed the need for cooperation and sharing that is vital to resisting and prosecuting fraud on a broad scale.

The annual Insurance Fraud Management Conference is a key event for the investigations and claim management community. The annual event is cosponsored by the NICB and ISO. Next year’s conference will be held in Las Vegas, March 21 to 24.

Thomas Mulvey is the national director of SIU and Claim Services for ISO Claims Solutions. He is also the coordinator of the Insurance Fraud Management Conference.