Investigative & Forensics

Working as a 52-year-old librarian at a California State Prison proved to be too much for Rosa Cazares Pitones, who was arrested and charged with three counts of insurance fraud and one count of grand theft in March.

It is clear that the time has come for both carriers and self-insured entities to adopt specialized means by which to investigate post-termination claims and address this emerging crisis head-on.

A lot has been written about criminal activity resulting in losses due to P&C fraud. While coverage is pervasive in the media, not enough has been written about strategies to prevent these losses.

To find out more about the surge in recent pirate attacks and related insurance implications, Claims spoke with Howard Mills, Deloitte's chief insurance advisor and former New York State insurance superintendent.

At ACE, Joseph Werhle, NICB president and CEO, will discuss their integrated plan to focus on five core disciplines while helping insurers discern the many unsavory flavors of fraud.

To help detect and deter fraud, there is now a frequency-based technology that determines veracity by analyzing brain activity conveyed through the voice, not through physiological response.

Dennis Costello and his team at Second Chair Software have been working with insurance carriers to ob-tain video depositions of witnesses in litigation so that claim personnel can evaluate witnesses from their desktops.

Claim severity due to fraud is a huge problem for insurance carriers. Although there are many factors contributing to the rise of auto injury medical claim costs, fraud is clearly one expense that carriers can and should address.