Coalition Against Insurance Fraud

Mom set house on fire with 11-year-old daughter inside for insurance money. An 11-year-old girl who found herself in a burning home at 3 a.m. was the?pawn in an insurance scam, according to investigators in Louisiana.?The 36-year-old woman was arrested Nov. 12 in nearby Denham Springs and charged with aggravated arson, cruelty to a juvenile, insurance fraud and misdemeanor theft.?The allegations against her:?It happened Saturday, Oct. 19, at a rural home north of Walker, and the woman and child were both inside when the fire was reported. The unnamed woman had accepted financial assistance from a disaster relief organization in the wake of the fire. After confirming she had filed an insurance claim for the fire damage, a warrant was obtained for her arrest. Both the woman and child left the fire safe and unharmed. https://lnkd.in/ggWYr9rq

The Coalition champions International Fraud Awareness Week. The Coalition Against Insurance Fraud is proud of our achievements in stopping fraud.?This annual campaign, led by the Association of Certified Fraud Examiners, shines a light on the costs and impacts of fraud, including insurance crimes that hurt millions of Americans each year. Insurance fraud – ranging from staged accidents, falsified claims, and billing fraud scams perpetrated by unscrupulous care providers and contractors – costs hundreds of billions annually. Everyone can have a hand in stopping insurance fraud, being aware of how to avoid scams to protect yourself and neighbors. You can see all of our anti-fraud offerings for this year's International Fraud Awareness Week right now?on our website. https://lnkd.in/gjtarAX9

Oklahoma issues AI guidance for insurers in line with NAIC Bulletin.? Oklahoma Insurance?Commissioner Glen Mulready?has released?Bulletin 2024-11, providing insurers with regulatory guidance on the ethical use of artificial intelligence (AI) in insurance operations. This bulletin aligns with the National Association of Insurance Commissioners (NAIC)?bulletin on insurer use of AI, setting a nationwide standard for the responsible deployment of AI in the industry. Emphasizing innovation and consumer protection, Commissioner Mulready stated that AI should enhance efficiencies and improve customer experiences while adhering to fairness, transparency, and accountability. The bulletin requires insurers to comply with state insurance laws, maintain robust governance over AI systems, and ensure transparency through documentation and audits. With Oklahoma joining other states like Alaska, Maryland, and Pennsylvania in adopting the NAIC model, Commissioner Mulready urged insurers to review the guidance carefully and seek?assistance?if needed. This development highlights a growing focus on ethical AI use in the insurance industry, mirrored globally by the European Union’s adoption of its groundbreaking AI regulation. https://lnkd.in/gz-VH-VA

Oklahoma issues AI guidance for insurers International Fraud Awareness Week and a Mother sets her house on fire with her 11-year-old daughter inside All of this and more in this week's #FraudNewsWeekly #insurancefraud https://lnkd.in/gfmJmDWh

New Jersey has a new Insurance Commissioner Opportunistic fraud on the rise Viral auto fraud video leads to charges All this and more in this week's #fraudnewsweekly #insurancefraud https://lnkd.in/gbX5bbuh

Potential insurance fraud knows no bounds as seen in this video reported by WKYC News, when it comes to creativity, but the Coalition Against Insurance Fraud strongly discourages anyone from attempting such acts. In today’s world of advanced surveillance and fraud detection systems, insurers are equipped to identify even the smallest acts of deceit. The consequences—ranging from public embarrassment to potential criminal conviction—are simply not worth the risk. The Coalition collaborates daily with its members to strengthen the fight against fraud, and we urge everyone to contribute to this effort by reporting suspicious activities and choosing integrity over deception. https://lnkd.in/e-2r2t2m

The Coalition would like to honor all of those who have served. #VeteransDay2024

Cardiologist loses medical license over years-long fraud scheme.?The New Jersey State Board of Medical Examiners has permanently?revoked the medical license?of Fazal Panezai, MD, a cardiologist who faces up to 10 years in prison for participating in a years-long fraud scheme.?Panezai has?already admitted?to submitting false claims to at least six health insurance benefit programs for office visits that either never happened or did not happen for the length of time he claimed. For example, he once submitted claims for 27.9 hours of office visits that he said all occurred on the same day. The scheme, which lasted from January 2017 to December 2022, included more than $1.9 million in false claims.?Panezai also faces an unrelated charge of fourth-degree criminal sexual contact due to an alleged incident with a patient in 2018. The New Jersey Office of the Insurance Fraud Prosecutor is currently investigating the patient’s claim. https://lnkd.in/gYp9qHAJ

The Coalition would like to thank our amazing panelists for another amazing webinar! This week, the Coalition hosted another webinar in our new?TrendTalk?series.?We would like to congratulate our hosts,?Jeff Ferrand, Vice president of Fraud Services ([email protected]), and?Micki Lockard, Claim Director and Long Term Care Operations for CNA ([email protected]). The newest episode in the series is dedicated to Long Term Care Fraud. If you missed the initial presentation of the webinar, it?will be available on our website soon.

New Mexico governor issues first antifraud proclamation, aligning with International Fraud Awareness Week.?Congratulations are in order to the local IASIU New Mexico chapter, who led the effort to secure?New Mexico's first Antifraud Proclamation from the Governor?in partnership with IAISU and fellow insurance fraud fighters. The proclamation comes just in time to kick off International Fraud Awareness Week, celebrated from November 12-23, 2024, marking 25 years of this annual event dedicated to combating fraud worldwide. Fraud Awareness Week shines a spotlight on the profound impact of insurance fraud on individuals, businesses, and communities, especially across New Mexico. As a Supporting Organization of the event, New Mexico’s Office of Superintendent of Insurance (OSI) Insurance Fraud Law Enforcement Division will partner with the Association of Certified Fraud Examiners (ACFE) as Ambassadors, helping to raise awareness and educate communities on recognizing, preventing, and reporting fraud. Through collaborative efforts like these, New Mexico fraud fighters are raising awareness, promoting strong antifraud practices, and helping to protect the state’s economy. Cheers to OSI for safeguarding New Mexicans and championing a successful Fraud Fighting Week! https://lnkd.in/g3tVqQX3