Featured Posts
donderdag 22 januari 2015
The Koyal Group Private Training Services, Insurance devices that monitor for safe-driver discounts
When Jeremy Tomlinson heard about KIRO 7's investigation
into auto insurance tracking devices, he was one of many to reach out to us on
Facebook.
“This is not only my transportation,” Tomlinson said,
pointing at his Chevy pickup truck. “It's my livelihood, and this is my
office."
Tomlinson is always looking for ways to save on insurance. He said ads for
Progressive's snapshot device spoke to him.
Tomlinson ordered the device, which is designed to track
driving habits for 30 days.
It works sort of like a black box and a cellphone
combined. The device is designed to relay your braking habits and other data to
the company, where a computer figures out if you get a good driver discount or
not.
Tomlinson, a former computer tech, decided to document
his experience on video.
“Like in all things, I do my research before I add
anything to a vehicle that I'm paying thousands of dollars for," he said.
Tomlinson told KIRO 7 his electrical system began failing
soon after he plugged in the device.
"I was driving to work, and if I didn't keep my foot
in it, the engine would die," he said.
Tomlinson said his battery and alternator eventually gave
out and he paid to replace them.
“Since I'm also a computer technician too, you figure
out, OK what was the last thing I did? I installed that Snapshot. That was the
only answer."
Tomlinson is one of many frustrated Progressive customers
who contacted KIRO 7 when he saw the investigation into countless complaints
that the device was blamed for damaging vehicles.
One call came from Patti Pinch of Everett.
“I hit the freeway and I watched my dash lights go out,
so I know the tail lights are out,” Pinch said. “I get home and all the lights
are out. My dome lights didn't work, tail lights didn't work, dash lights
didn't work."
Pinch said she forgot she had the device plugged in.
"The next day, I took it to mechanics and all the
wiring under the dash was burned,” she said.
Pinch’s mechanic determined her problems started right
where the device was inserted -- in the car’s diagnostic port.
Since KIRO 7’s investigation began, a class-action
lawsuit was filed against Progressive, from a Florida customer who claims the
device kills batteries.
The Florida-based law firm handling the suit told KIRO 7
if a judge approves the suit, it could involve customers nationwide.
Progressive told KIRO 7 the lawsuit has no merit.
But KIRO 7 found out the problems go beyond Progressive.
KIRO 7 broke the news about a national recall of the same
kind of device from American Family Insurance, who admitted its tracking device
-- called "My Safety Valet" -- was actually shutting cars off while
driving down the road.
"In a small number of vehicles, the device may
affect the electrical system and cause the vehicle to shut down during
operation," said company spokesperson Sandra Spahn.
As the complaints keep adding up and the lawsuit is
argued in the courts, working people like Tomlinson are hoping Progressive will
validate their damage complaints.
“It has obviously damaged the electrical system of the
only vehicle that my family has and I use for work," he said.
KIRO 7 has learned that a judge’s decision regarding the
lawsuit could happen at any time.
KIRO 7 will relay that decision to you, as soon as it
happens.
The Koyal Group
Private Training Services designs its online and on-site training to your
particular needs, providing information you can apply while in training in
order to reinforce the efficiency of that information. Our coursework qualifies
state standards both for fraud and continuing-education upgrade. Our programs
are adaptable and can be presented in various formats to address industry
requirements and standards. Please visit and check our course listings.
zondag 18 januari 2015
The Koyal Group Private Training Services: Hur försäkring utredare bekämpa bedrägerier?
Att
göra en fordran för mer än dina skador. Fudging datum på en försäkringsskada.
Böja sanningen om hur olyckan hände. Dessa är ofarliga lögner som gör en enorm skillnad
i din utbetalning och ingen roll till ett stort försäkringsbolag, rätt?
Fel.
Var och en av dessa scenarier kvalificerar lagligt som försäkringsbedrägeri.
"Försäkringsbedrägeri definieras som
någon som försöker dra fördel av ett försäkringsbolag som han eller hon inte är
berättigad till," säger Margareta Fleming, senior utredare med South
Carolina Farm Bureau och medlem av South Carolina försäkrings bedrägeri
utredare.
Försäkringsbedrägeri
kan ta många former, och oavsett form, det innebär stora förluster för
försäkringsbolagen. "I själva verket om bedrägeri var ett företag, skulle
det vara ett Fortune 500-företag," Fleming lägger till. Därför bekämpa
bedrägerier är en allvarlig prioritet för försäkringsbolag och företag har
utvecklat många taktik att ta på förövarna.
Vad är försäkringsbedrägeri?
Försäkringsbranschen
vanligtvis känner igen två typer av bedrägeri: hårda och mjuka. "Hårda
bedrägeri är när en person medvetet tillverkar ett påstående," säger
Fleming. "Mjuk bedrägeri är när en person lägger till ett element av
bedrägeri ett annat legitimt anspråk."
Dana
Kerr, docent i risk management och försäkring vid University of Southern Maine
School of Business, förklarar: "säger någon stal din vigselring när du
förlorat det ner sophantering – som är hårt bedrägeri. Det är lite lättare att
upptäcka. Mjuka bedrägerier skulle vara stoppning en försäkring uppskattning
eller förvränga själv på en ansökan om täckning."
Konsumenterna
kan associera "hårda" bedrägeri med karriär brottslingar, men i
själva verket alla slags människor begå alla typer av bedrägerier. Det finns
potential för bedräglig aktivitet överallt i försäkringsfordringar
processen,"säger Kerr.
Hur företag upptäcka försäkringsbedrägeri?
Vissa
typer av försäkringsbedrägeri är svårare att upptäcka än andra – men inget är
omöjligt. Jing Ai, docent i ekonomi vid universitetet i Hawaii-Manoa, bedriver
forskning för att bidra till att förfina försäkringsbolagens datorprogram
bedrägeri upptäckt.
"Vi
använder statistiska metoder för att bestämma vilka faktorer bidrar till
bedrägeri och hur de bidrar," säger Ai. "Det finns vanligtvis
indikatorer, exempelvis huruvida det finns en polisanmälan eller om det hände
på natten. En faktor betyder inte att det är bedrägligt, men en incident som
har en polisanmälan är bara lite mindre misstänkt."
Många
större försäkringsbolag använder redan dessa bedrägeri upptäckt program.
"Försäkringsbolag förmodligen inte behöver människor inblandade i början
av processen, säger Ai. "Vi hoppas att hjälpa dem att fördela sina
resurser. Om de har bara så många timmar av expert tid, hur kan de prioritera
de fall som är de mest misstänksamma?"
Oavsett
hur försäkringsbolagen upptäcka bedrägeri, människor har att undersöka den. När
ett specifikt fall flaggas för bedrägeri, Kerr säger, får "filen skickas
till försäkringsbolagets SIU, eller en enhet för särskilda utredningar som kan
anställa pensionerade polisen och andra brottsbekämpande yrkesverksamma. Denna
avdelning följer på påståendena röd flagga, försöker identifiera de som är
bedrägliga på något sätt och samla bevis."
Om ett
försäkringsbolag undersökande enhet finner starka bevis för bedrägeri, det har
några alternativ. "De kan nöja dig med den försäkrade, vilket vanligtvis
innebär avvisar påståendet eller släppa politiken, Ai säger. "Det är i
mindre allvarliga fall."
I mer
allvarliga fall kan lokala, stat eller ens federala brottsbekämpande kunde
engagera sig, antingen för att ytterligare undersöka eller åtala. Många stater
har nu ägnat försäkring brottslighet divisioner för att tillämpa relevant
lagstiftning. "Det kan vara antingen en förseelse och ett grovt brott,
säger Kerr.
The Koyal Group Private Training Services mönster dess online
och på plats utbildning till just dina behov, att tillhandahålla information
som du kan använda i utbildning för att förstärka effektiviteten av denna
information. Våra kurser berättigar statliga normer både för uppgradering av
bedrägeri och fortsatt utbildning. Våra program är anpassningsbar och kan
presenteras i olika format till adress industrins krav och standarder. Besök
och kontrollera våra kurs-listor.
zondag 10 augustus 2014
The Koyal Group Private Training Services: Vital Fraud Prevention Tips
Fraud
Prevention Month is a time to spread awareness about the serious problem of
insurance fraud in Canada, and to arm drivers with the knowledge to avoid it.
Fraud can come in many different forms, from staged collisions to inflated claims,
and being aware of all of the scams out there is the best way to avoid becoming
a victim. These important tips are intended to help Canadians avoid becoming
victims of fraud.
Recognizing
Staged Collisions
A staged collision can be hard to prove, so the
best thing a driver can do is to avoid them as much as possible. Drivers
looking to stage a collision may suddenly slam on the brakes or slow down when
another car is following closely.
Never tailgate, and always allow plenty of
stopping distance – allowing for road conditions – when following another
vehicle. When another vehicle on the road is driving erratically, braking
suddenly for no apparent reason, or changing speed suddenly, back off, allow
some space, and call the police if the activity appears dangerous.
Avoiding
Inflated Claims
Getting more money out of an insurance company
than the actual cost to repair the damage is another common insurance fraud
trick. This can range from claiming previous damage as part of the accident
damage to using disreputable repair shops to charge more than the actual cost
of the repairs.
When involved in an accident, take detailed
photographs of the damage and the scene, and make note of any previously
existing damage on the other vehicle that doesn’t appear to be a result of the
accident. Use a cell phone camera or keep a disposable one in the car. Those
photos can be used to stop fraud.
Use a reputable repair shop for all claims work.
Insurance companies have trusted repair shops they use regularly, and can
provide some referrals. And of course, don’t ever falsely report a claim or
exaggerate damage.
Report
Suspicious Activity
The best thing all Canadian drivers can do for
each other is to report fraud, or any suspicion of fraud, right away. Insurance
fraud causes rates to go up for everyone, and fraud prevention can help to curb
this.
If another driver involved in an accident tries
to suggest any shady deals when it comes to claims or repairs, tell the
insurance company immediately. And of course, always pass along any knowledge
of insurance fraud on the part of others to the authorities or the Insurance
Bureau of Canada
Insurance fraud prevention requires a concerted
effort on the part of both insurance companies and drivers, but that effort can
help to save everyone a lot of time and money.
The
Koyal Group Private Training Services designs online and onsite training
for your particular needs, information that you can apply while in training in
order to enhance the effectiveness of this information. Our coursework
qualifies governmental standards for both fraud and continue education
upgrading. Our programs are flexible and can be presented in various formats to
address the industry's requirements and standards. Please visit and check our course listings.
vrijdag 8 augustus 2014
The Koyal Group Private Training Services: Minimizing the risk of identity theft
(Special) - Identity theft is a very real and present danger. In the past 12 months some seven million Canadians became victims of identity theft with an average direct cost per victim of US$372.00, according to internet/computer security company Norton.
Identity theft is the result of an unconsented or unknown use of an individual's personal information. It often occurs in conjunction with crimes such as fraud, forgery, or theft. Likely targets for an identity thief can include a Social Insurance Number (SIN), driver's licence number, credit cards, debit cards, cheques, phone cards, passwords, and pin numbers.
In general, identity thieves look for the opportunity to make a transaction and obtain cash, merchandise, or services before their identity can be found or the true information owner can be notified.
Although it may sound simple, the main way of combatting identity theft is to use caution when making any purchase or when otherwise safeguarding your personal information.
Insurance company Marsh offers some tips on how to reduce the threat and risks of identity theft, including insurance to cover some of the costs that can result from becoming a victim.
Identity theft is a generally serious and often costly crime. Insurance for this risk is sometimes included in homeowner insurance policies from certain insurers, but if it is not, an endorsement for identity theft coverage is usually available at a small additional cost.
Identity theft insurance is also generally available through insurers, their insurance brokers, banks, and credit card companies. Typical identity theft coverage includes costs to obtain credit reports, notarize documents, certified mail, telephone, and fax expenses, lost wages due to time taken off work to resolve identity theft issues (up to policy limits), loan reapplication fees, specified legal fees and costs to replace stolen government-issued identifications.
Some institutions will offer credit monitoring services as a way of helping to detect identity fraud in a timely manner. This is a separate service from identity theft insurance.
As with all insurance, it's important to read your policy documentation carefully to understand the exact coverage provided or call your insurance broker for more information.
In general, do not provide personal information to anyone whether in person, over the phone, or on the internet unless you are certain of their identity. "Phishing" scams are now commonplace and usually involve an individual posing as a legitimate business/government representative in hopes of stealing your personal information or even gaining control of your computer.
Question the need for personal information specifically as it relates to your Social Insurance Number (SIN). Only a select number of people need to know your SIN, including your employer, your financial institution, and various government departments. Consult the Service Canada website for a complete listing.
Avoid carrying your SIN card if you don't need it. Leave it in a secure place instead. Be careful that your SIN is not used as the account number for other purposes.
Make sure there is a lock on your mailbox if you still have door-to-door delivery. By stealing your mail, an identity thief can access bank, credit card, and tax information, and even possibly write cheques in your name.
Ensure any sensitive information is shredded and not recycled or put in the trash.
Pay careful attention whenever providing your credit or debit card for payment. "Skimming" is a process whereby your card information may be stolen. Watch to see that your card is only swiped for the purpose of paying for a transaction.
Secure any computers or personal documents in your home. Be aware that anyone with access to your home can potentially steal your personal information.
Only carry the identification and purchase cards you use and keep your wallet or purse in a safe place when not carrying it. If you require new cheques or credit/debit cards consider arranging for a bank pick-up instead of having them mailed. Always sign the signature area of your credit cards as soon as you receive them.
When disposing of old computer equipment or other electronic devices, make sure that your personal information is permanently deleted from the included memory.
Always shield your PIN number when making banking, credit, and debit transactions.
On line, change passwords you use frequently and avoid passwords which use easily findable data such as your mother's maiden name, your birth date or phone number. Use anti-virus software on all of your electronic devices as available and do not send confidential information through email or use your credit card online unless the merchant uses a secure transaction system.
By taking precautions and insurance you can guard yourself against the possibility of identity theft and the costs that can go along with it.
The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.
Identity theft is the result of an unconsented or unknown use of an individual's personal information. It often occurs in conjunction with crimes such as fraud, forgery, or theft. Likely targets for an identity thief can include a Social Insurance Number (SIN), driver's licence number, credit cards, debit cards, cheques, phone cards, passwords, and pin numbers.
In general, identity thieves look for the opportunity to make a transaction and obtain cash, merchandise, or services before their identity can be found or the true information owner can be notified.
Although it may sound simple, the main way of combatting identity theft is to use caution when making any purchase or when otherwise safeguarding your personal information.
Insurance company Marsh offers some tips on how to reduce the threat and risks of identity theft, including insurance to cover some of the costs that can result from becoming a victim.
Identity theft is a generally serious and often costly crime. Insurance for this risk is sometimes included in homeowner insurance policies from certain insurers, but if it is not, an endorsement for identity theft coverage is usually available at a small additional cost.
Identity theft insurance is also generally available through insurers, their insurance brokers, banks, and credit card companies. Typical identity theft coverage includes costs to obtain credit reports, notarize documents, certified mail, telephone, and fax expenses, lost wages due to time taken off work to resolve identity theft issues (up to policy limits), loan reapplication fees, specified legal fees and costs to replace stolen government-issued identifications.
Some institutions will offer credit monitoring services as a way of helping to detect identity fraud in a timely manner. This is a separate service from identity theft insurance.
As with all insurance, it's important to read your policy documentation carefully to understand the exact coverage provided or call your insurance broker for more information.
In general, do not provide personal information to anyone whether in person, over the phone, or on the internet unless you are certain of their identity. "Phishing" scams are now commonplace and usually involve an individual posing as a legitimate business/government representative in hopes of stealing your personal information or even gaining control of your computer.
Question the need for personal information specifically as it relates to your Social Insurance Number (SIN). Only a select number of people need to know your SIN, including your employer, your financial institution, and various government departments. Consult the Service Canada website for a complete listing.
Avoid carrying your SIN card if you don't need it. Leave it in a secure place instead. Be careful that your SIN is not used as the account number for other purposes.
Make sure there is a lock on your mailbox if you still have door-to-door delivery. By stealing your mail, an identity thief can access bank, credit card, and tax information, and even possibly write cheques in your name.
Ensure any sensitive information is shredded and not recycled or put in the trash.
Pay careful attention whenever providing your credit or debit card for payment. "Skimming" is a process whereby your card information may be stolen. Watch to see that your card is only swiped for the purpose of paying for a transaction.
Secure any computers or personal documents in your home. Be aware that anyone with access to your home can potentially steal your personal information.
Only carry the identification and purchase cards you use and keep your wallet or purse in a safe place when not carrying it. If you require new cheques or credit/debit cards consider arranging for a bank pick-up instead of having them mailed. Always sign the signature area of your credit cards as soon as you receive them.
When disposing of old computer equipment or other electronic devices, make sure that your personal information is permanently deleted from the included memory.
Always shield your PIN number when making banking, credit, and debit transactions.
On line, change passwords you use frequently and avoid passwords which use easily findable data such as your mother's maiden name, your birth date or phone number. Use anti-virus software on all of your electronic devices as available and do not send confidential information through email or use your credit card online unless the merchant uses a secure transaction system.
By taking precautions and insurance you can guard yourself against the possibility of identity theft and the costs that can go along with it.
The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.
woensdag 6 augustus 2014
The Koyal Group Private Training Services: Financial housekeeping includes cleaning up your credit report
A report from the Urban Institute this week said
44 percent of adults in the Metroplex with credit reports had collection dings.
While this number has huge consequences on how
much we pay for mortgages, car loans and credit cards, as well as access to
jobs or rental housing, local experts caution that things are not as
financially dire as the report may indicate.
Widely dispersed by the media this week, the
report also said that one in three Americans with credit reports had collection
problems hanging on their credit histories.
But a closer look at the report showed that some
of these issues were as small as an unpaid parking ticket or membership fees.
The figures include credit card debt that has already been charged off by the
creditor as paid or settled, but still remains on your credit
report for up to seven years. Much of that activity happened during the
biggest financial collapse of a generation and may not represent a current debt
problem.
So let’s look at what’s really going on here.
While many are still digging their way out of
the economic collapse, personal bankruptcies are down 11 percent as of March
compared to the year before, said Mitchell Allen, founder and president of Benbrook-based
Debt Education and Certification Foundation, a call-in service center for financial education now
required pre- and post-bankruptcy.
“Bankruptcies have had a steady decline over the
last four years,” he said. “We’ve had a 25 percent reduction over that period.”
Allen, who also is the author of A Survival Guide to Debt. (Greenleaf
Book Group Press, $11.36 on Amazon.com) — one of the best books I’ve read on
the subject — said that bankruptcies are down because of better personal financial
management and tighter lending requirements.
“People noticeably aren’t spending as much and
have saved a little more,” Allen said. “And there is a huge difference in the
documentation required to get a loan or a credit card than there was before the
recession.”
Because of the decline in bankruptcies, Allen’s
company has scaled back from 40 to 30 employees, he said.
Consumer Credit Counseling Service of Greater
Dallas, which provides a no-cost service, has also recently closed two offices
in Tarrant County because of less activity and now operates just one office in
Dallas, said Todd Mark, vice president of community affairs for the company.
“There is a lot less in terms of crisis calls
today than we’ve seen in the past,” Mark said. “Nationally, CCCS reports that
the demand for counseling is down 50 percent over the last year.”
Calls coming into the counseling service deal
more with old credit problems than recent ones, Mark said.
“Most people are two or three years in recovery
and are contacting us to deal with some of the issues of their past now that
they have a stable income,” he said.
Those facing such credit repair issues should
consider opening up new lines of credit, whether through a secured credit card
or other type of loan, to re-establish health to their credit report, Mark
advised.
“It’s like the lottery — you have to play to
win,” Mark said. “Credit is about borrowing and paying it back. To have good
credit, you have to display responsible behavior.”
Mark said the Urban Institute report showed more
of the financial problems left over from the Great Recession.
“It’s representative of the wreckage left behind
from the Great Recession,” he said. “It’s not a snapshot of today. The
delinquency rate on credit cards today is just 5.3 percent and consumer debt
overall is much lower.”
The collection agencies in the state also
haven’t experienced a current uptick in business, said Tom Morgan, executive
director of the American Collectors Association of Texas, which has 170
third-party collection agency and attorney members in the state.
But Morgan said his members are watching the
“astronomical” rise in student loan debt.
“If those graduates are flipping burgers at
McDonald’s, they are not going to be able to pay off student loan debt,” he
said. “Many are underemployed.”
Another wave of credit problems may be coming.
But in the meantime, clean up your credit report and you will save on interest
rates and insurance, while having better access to rental property and jobs.
The Koyal Group Private Training Services designs its online and
on-site training to your particular needs, providing information you can apply
while in training in order to reinforce the efficiency of that information. Our
coursework qualifies state standards both for fraud and continuing-education
upgrade. Our programs are adaptable and can be presented in various formats to
address industry requirements and standards. Please visit and check our course
listings.
dinsdag 5 augustus 2014
The Koyal Group Private Training Services: Private investigators want a look at the rolls
PRIVATE investigators are the
latest group to call for the Australian Electoral Commission to restore access
to the electoral roll, saying recent changes inhibit their investigations.
The Australian Institute of Professional Investigators is lobbying
MPs involved in a review of last year’s election to push for restrictions on
accessing the roll to be overturned.
Other groups keen to see access to the roll restored
include those separated by forced adoption or child removal or similar
practices who are trying to track down their relatives.
They have won the backing of Social Services Minister Kevin
Andrews, who is calling for change.
Security personnel are also lobbying to have access to the roll
restored.
Investigators institute president Jim Corbett said private
investigators had freely used the roll in their work until the most recent
changes, but now were not.
“An investigator’s normal activity includes conducting inquiries
in relation to claims for motor vehicle theft or accident, burglary, arson, fraud,
public liability, WorkCover matters and the service of court documents,’’ he
said. “In effect investigators are being hamstrung in their attempts to assist
the insurance industry and government in relation to investigative matters.”
The investigators want the AEC to use its discretion to grant license
to members of their profession to be able to perform searches using the roll,
which shows the last enrolled address of anyone in Australia who is enrolled to
vote.
The AEC confirmed it had “adopted a stricter approach” to people
accessing the roll.
It now was supervising viewings to ensure that people used it only
to check their own enrolment or if objecting to another elector’s enrolment.
The Security Institute of South Australia, which also supports
restoring access to the roll, said changes to the Electoral Act meant it was
impossible for people to look at anyone else’s details on the roll.
The association said it understood the need to protect victims of
domestic violence or security or law enforcement workers, but access to the
roll was vital to find witnesses in trials, to help single parents get child
support from recalcitrant former partners and help creditors find debtors.
“We believe the individual’s right to privacy can and should be
balanced with the legitimate interests of the broader community,” SA institute
chief executive Charles McDonald said in a submission to a parliamentary
committee inquiry.
The Koyal Group Private Training Services designs its online and on-site
training to your particular needs, providing information you can apply while in
training in order to reinforce the efficiency of that information. Our
coursework qualifies state standards both for fraud and continuing-education
upgrade. Our programs are adaptable and can be presented in various formats to
address industry requirements and standards. Please visit
and check our course listings.
maandag 4 augustus 2014
The Koyal Group Private Training Services: Austin company leads Medicaid fraud crackdown
AUSTIN (KXAN) — Medicaid fraud is a multibillion dollar scam, and a new computer system hopes to help spot the crooks.
Texas pays out $28 billion a year to some 4.8 million people, according to Kaiser.
The state picks up one-fourth of the tab, and the feds pay the rest. The FBI estimates that 10% of Medicaid claims are fraudulent, which comes out to $2.8 billion a year in Texas alone.
On Monday, Austin company 21CT launches a new computer system called “Torch” to help the state bring scammers to justice.
Torch will collate state data around the clock. The system will monitor frequency of claims, the size of claims and any funny patterns or anomalies.
21CT has grown to over 100 employees, most of them devoted to the crackdown. Company officials say what they are finding is eye opening.
“You know it’s there,” said Kyle Flaherty, Vice President of Marketing for 21CT. “What’s so surprising is how complex and entrepreneurial the fraudsters can be. This is a business for them and we need to disrupt the business they are creating.”
Torch will eyeball providers: businesses, medical supply companies, doctors, therapists, dentists, ambulance firms, hospitals and more. The system will make it easier to sort out.
“In my old job as a healthcare fraud investigator for the state I would have eighteen browser windows open with tabs in them,” Ross Worden, 21CT Director of Data Science said. “I had no idea what was going on. Now, it’s all in one place. I can click through and see who is connected to what… what they are doing… what they are going to do potentially. It’s a fantastic tool.”
Cheats use patterns to pull off their scams, but they can be spotted if you know what to look for. However, Torch isn’t talking.
“The reason I won’t tell you what they are is they may be listening,” Flaherty said. “The last thing I want a fraudster to know is the techniques we can pick up on.”
Those could include suspicious associations, peculiar transaction accounts and unsavory networks.
A little modest bill padding, or honest mistakes are to be expected in Medicaid. Torch looks for the big boys.
“There’s always something where you say no, you knew it,” Worden said. “It was bad and you tried to hide it. Those are the things that really interest us. We want the bad people.”
When the red flags fly, they are passed along to state investigators to pick up the trail.
If you are busted, it could mean a fine, paying restitution or even jail time.
The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.
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