S.I.B.S. Approach: Evaluating the Merit of a Claim
First Published 3/10/2015, Updated 5/6/2021 The success of properly processing an insurance claim requires due diligence/fiduciary duty as an insurance professional to evaluate each claim
Holiday Season Claimant Activity
We have officially begun the holiday season; Thanksgiving, Christmas, and New Year’s Eve are all right around the corner. This time of year brings Football,
Fraud can and will arise during COVID-19 pandemic
The Fraud Triangle shows why there is an element of fraud that can and will arise out of this unfortunate crisis. All types of insurance
Why SIUs are Valuable to Your Bottom Line
SIUs – Perception & Reality With new state mandated compliance regulations, Special Investigative Units (SIUs) are utilized to fight and expose fraud — whether it
Is your facility safe… Do you have a plan?
According to the Bureau of Labor Statistics Census of Fatal Occupational Injuries (CFOI), of the 5,250 fatal workplace injuries that occurred in the U.S. in 2018,
Fun, Frolic, Fall and Fraud
Tis officially the holiday season! Halloween, Thanksgiving, Christmas, and New Year’s Eve are all right around the corner. This time of year brings Football, Fall
Catastrophe Fraud: Learning from the Past
When natural disasters happen, having all the variables in place to ensure a smooth claims process is key. There are many times when, due to
Summer: The Season of Justice
Memorial Day, 4th of July, Mother’s Day, Father’s Day, school vacation, family vacations, sports activities, beach activities and yard maintenance. What do all these things
Are You in Compliance?
Each state has different requirements to effectively fight against fraud, and it is the responsibility of the insurer to stay up to date on the
Active Shooter & Workplace Violence Response Program
According to the Bureau of Labor Statistics Census of Fatal Occupational Injuries (CFOI), of the 4,679 fatal workplace injuries that occurred in the U.S. in
Hurricane and Storm Fraud
The season for Tropical Storms and Hurricanes are upon us. Hurricane Harvey dropped more than 50 inches of rain in Houston and went toward Louisiana,
Slip & Fraud: When a Slip & Fall is Intentional
By Jeff Schneider, Gene Kissane and Robert Brumell. Originally published in Litigation Management Magazine, winter 2013. Slip and fall claims have been around since businesses
Fighting Fraudulent Lawsuits with RICO
By Howard Kaplan, Robert H. Brumell III – Originally published on TheCLM.org Businesses and insurers often deal with fraudulent lawsuits. Two recent lawsuits, aggressively using the Racketeer Influenced
Catch me if you can…
Ever had one of those claimants who just won’t settle no matter what you do? Ever have one of those claimants that you just can’t
Keys to a Successful Workers Comp Investigation
Every corporation has a number of internal components that need extra scrutiny, and workers’ compensation fraud is one of these important components. Even as the