7:50 a.m. to 9:40 a.m.         Breakout Sessions (choose one)

AM1     Ethics                                                             Tom Usery and Steve Feil, Parker Straus

Steve Feil is an associate attorney with Parker Straus, LLP in its Houston office.  He handles personal injury civil litigation, with an emphasis on complex insurance fraud, and insurance coverage.  He has briefed cases before the Court of Appeals and regularly appears in trial courts throughout the state.  He has conducted numerous examinations under oath throughout the United States.  Prior to his private practice, Steve was an Assistant District Attorney for the Nueces County District Attorneys Officer from 2006 to 20011 where he personally tried over forty cases to jury verdict for crimes such as Aggravated Robbery and Intoxication Assault.  He also prosecuted many insurance fraud and embezzlement cases and advised law enforcement investigators on case investigation and presentation.  Steve is a 2006 graduate of the University of Richmond School of Law where he participated in the Juvenile Delinquency Clinic and a 2003 graduate of Texas A&M University.  While at A&M, Steve was a member of the Corps of Cadets.

AM2     Wind, Hail and Roofing Fraud                            Brandon English, HAS

Mother Nature is NOT Scared of Heights: Roof Covering Conditions vs. Real-World Effects of Wind and Hail Impact.

The course is intended to be an overview of the fundamentals of wind damage and hail damage assessment with particular attention to site investigation techniques utilized for comparison of naturally occurring effects of wind/hail and those from other simulated sources. Some of the fundamentals utilized for this comparison include: principles of airflow; principles of hail size/fall velocity; how to research wind/hail events, how to understand research regarding the progression of damage from wind (Saffir scale, EF-Scale, etc.) and hail impact (UL, FM, and private sector); and what areas of a structure are more susceptible to the effects of wind (specific wind pressure zones) and hail impact. Real-world examples of hail and wind effects on various structures will be utilized to demonstrate wind/hail damage progression fundamentals and provide comparison between these real-world and simulated sources.

Mr. English is nearing the end of his 15th year of structural engineering experience. Mr. English has investigated various types of residential and commercial structures to determine cause(s) and extent of damage and relation to sources like: foundation movement, wind, flood, blasting/vibration, construction deficiencies, vehicle impacts, debris/hail impacts, water ingress, fire, and other causes. Mr. English has deployed for more than ten Hurricane/Tropical Storm Events and also performed investigations on numerous tornado events throughout the United States. Additionally, Mr. English’s services has included assisting special investigation units in determining whether observed roof covering conditions are consistent with effects of wind/hail impact or are consistent with other simulated sources. Mr. English has a Bachelor of Science in Civil Engineering from Iowa State University, a Master of Science in Civil Engineering from the University of Houston, and expects to graduate with a Juris Doctor (law degree) from the University of Houston Law Center in December of 2013. Mr. English participates in the American Society of Civil Engineers (ASCE), the National Society of Professional Engineers (NSPE), and the ASTM E06 committee on Building Performance. Mr. English holds Professional Engineering (PE) licenses in Alabama, Louisiana, Minnesota, Mississippi, Texas, and Wisconsin.

10:00 a.m. to 11:50 a.m.    Breakout Sessions (choose one)

AM3     Interviewing Health Care Providers          Dr. Rick Wakefield, JD, DC, PA, IHC                              

Provider interviews can be difficult because they use a technical vocabulary that allows them to control the process, redirect the questions and create wiggle room.  This class will arm you with the confidence and knowledge needed to control the interview while maintaining a professional atmosphere and avoiding confrontation.  Dr. Wakefield uses slides and video clips to demonstrate reactions of providers to different types of questions. He brings clarity to the process of comparing patient EUO details to doctor explanations of modalities and therapies.  Participants will also explore how to evaluate non-verbal communication, review the medical records to prepare for the interview, design questions to encourage the provider to offer the detailed information needed, effectively segue into ownership and leasehold information, and close the interview. 

Dr. Rick Wakefield JD, DC, PA is the President and Founder of International Healthcare Consultants, Inc., a forensic consulting firm specializing in matters involving healthcare, insurance, science and law. For over 25 years Dr. Wakefield has been a lecturer, teacher, expert witness and consultant in the areas of medical billing and coding, fraud detection, injury causation, biomechanics and human factors.  He has a Bachelor of Science degree from the University of Florida, a Physician Associate (PA) degree from the University of Florida, Surgical Residency from the Yale University School of Medicine/Norwalk Hospital PA surgical residency program, Doctorate in Chiropractic degree from Life University, and Juris Doctorate Law Degree from John Marshall Law School.

AM4     Fraud Data Analysis                                      Michelle Bergeron, Esurance and Raun Bass, NICB

This two-part session will cover fraud data analysis. Excel Data Manipulation for Claim Investigations will cover a brief overview of Microsoft Excel and how basic features can help claim fraud data analysis. The importance of data analysis will be discussed in context of several SIU case studies and tips will be shared. SIU Analysis: How it can help your cases will demonstrate to students a basic foundation for the potential applications of data analytics with regards to insurance fraud. Topics include: potential sources for useful data, legal issues along with how analysts collaborate with field investigators to present the data. 

Michelle Bergeron is the SIU Analytics Manager at Esurance.  She began her career as a Paralegal, and has been in the financial industry for over 10 years.  Among her many accomplishments, she designed and implemented the Esurance SIU fraud analytics program from the ground up.  Using cutting edge technologies and innovative approaches, the program immediately produced results leading to the identification of multiple organized fraud rings and individual fraudulent claims. Michelle earned the Analyst of the Year award from the International Association of Special Investigation Units (IASIU) for her work at Esurance, and she was also featured in the Wall Street Journal.  In 2012, Michelle was selected as Claims Professional of the Year at the American’s Claims Event (ACE) & featured in Property Casualty 360.  Michelle is a sought after lecturer and fraud analytics expert with many industry presentations provided at the local, regional, and national level and her innovative approach to fraud detection has been adopted by several other companies.

Raun A. Bass serves as the Sr. Field Information Analyst for the NICB Texas Medical Fraud Task Force in Houston, Texas.  Mr. Bass began his career with NICB in 2006 as the Field Information Analyst for the NICB Gulf Coast Task Force.  The Gulf Coast Task Force was established in Baton Rouge, Louisiana after Hurricanes Katrina and Rita in late 2005.  Mr. Bass assumed the duties of Medical Fraud Task Force Analyst in July 2007, after serving as a NICB Analyst assigned to the Louisiana State Police Insurance Fraud and Auto Theft Unit in Baton Rouge, Louisiana.  Mr. Bass attended Loyola University of New Orleans where he graduated with a Bachelor of Business Administration in Management and a Bachelor of Business Administration in Marketing. 

1:00 p.m. to 2:50 p.m.         Breakout Sessions (choose one)

PM2    Field Safety for Investigators                            Tommy Short and Phil Clark, West University Place PD

This course is designed to give SIU and Claim professionals important field safety tips during personal interactions. Part one of this course will teach the student how to be aware of your surroundings, how to avoid potentially dangerous situations, ways to assess potentially dangerous people and the importance of alerting others when a dangerous situation occurs. The course will also teach ways to respond to conflict and how to use everyday objects and your surroundings for defense Participants will be provided with handout materials containing useful safety and awareness information and will have the option to participate in a practical exercise. There will be no physical contact during the session.

Tommy Short, a graduate of Baylor University, is both a police and insurance industry veteran.  He worked for 8 years as a police officer in Victoria, TX and Lakewood, CO, working as a patrolman, Detective, and SWAT team member.  Tommy has worked in the insurance industry since 1981, as a special investigator, Division Agency Manager, Unit Manager and Director.  Tommy holds the designations of Certified Insurance Fraud Investigator and is a member of the Society of Claims Law Associates.  Outside of his job, he has served as a member of the Grievance Committee of the State Bar of Texas, the Insurance Fraud subcommittee of the Texas Auto Theft Prevention Authority, the Privacy and Security Committee of the National Insurance Crime Bureau Board of Governors, and in various offices in the Texas Association of Special Investigation Units.  He is a member of the International Association of Auto Theft Investigators, ATAC, and the International Association of Financial Crimes Investigators.  He has been a member of the International Association of Special Investigation Units since 1991 and served as its President from 1999 through 2003.  He and currently serves on its Board of Directors. Outside of his work in the insurance industry, Mr. Short began training in the martial arts in 1993.  While he has specialized in Taekwondo, earning his 4^th Degree Black Belt and Instructor certification in two different organizations, he has studied many other martial arts, both modern and ancient.  He is proficient in both ancient and modern weapons.  His studies and practice has enabled him to be recognized as an expert in personal protection and self-defense. 

Phil Clark has been a police officer with the West University Place Police Department since December of 2008.  Officer Clark currently holds an intermediate peace officer license through TCLEOSE.  Officer Clark is a certified law enforcement instructor.  Officer Clark is also a field training officer, a public information officer, and an officer in charge. Officer Clark has been a police officer since 1994.  His first experience in law enforcement came in the state of New Jersey, where he worked as a police officer as well as a police dispatcher.  Officer Clark then worked as a police officer for the city of New Orleans in Louisiana.  Officer Clark spent five of his years with the New Orleans Police Department as a detective in the Metropolitan Auto Theft Task Force, where he became a vehicle identification specialist, among other duties.  Officer Clark has developed a course of instruction in the area of auto theft for the patrol officer. Officer Clark has also had the opportunity to become a certified personal trainer, along with additional certifications as a fitness specialist for law enforcement through training at the Cooper Institute in Dallas, TX. 

3:10 p.m. to 5:00 p.m.         Breakout Sessions (choose one)

PM3    Web Investigations                                      Doug Osborne, Kemper                                   

Web Investigations: Windfalls and Pitfalls in Emerging Internet Resources

This course will give the attendee a good basic foundation in the use of Internet resources and social networking for the purposes of insurance investigations. Emphasis will be placed on collection and preservation of relevant material in an ethical and legal way. Additionally, the attendee will learn ways in which the developed information can be used effectively in claims and underwriting inquiries.

Doug Osborne is a Large Loss manager / Investigator with The Kemper Special Investigation Unit. He has worked in the industry for 28 years, the last 20 of which have been dedicated to the investigation of suspicious Property, Casualty and Worker’s Compensation claims. Doug has investigated claims in all 50 states and in Canada and Mexico. Doug holds the designations of Certified Fraud Examiner (CFE), Certified Insurance Fraud Investigator (CIFI) and Fraudulent Claims Law Specialist (FCLS). He has presented seminars on the use of Social Networking in investigations and Web research all over the US for PLRB, IASIU, CPCU, and several associations.

5:10 p.m. to 6:00 p.m.         Bonus CE Hour

PM5    Motor Vehicle Theft Evaluation                 Jeff Abrams, Forensic Analysts, Inc.