Strengthening Fraud Training Through Strategic Partnerships

By Steve Beltz and Kim Lawrence

The fight against insurance fraud is a collaborative effort that calls for the expertise of diverse stakeholders, from law enforcement to insurance companies. This is where NICB’s Learning and Development (L&D) specialized training shines, serving not only as the crucial link connecting these sectors but also as a driving force in delivering quality and timely training. 

To ensure we bring our members the best learning experience, L&D partners with subject matter experts (SMEs) from member companies and law enforcement, as well as organizations like universities, industry experts, and training institutions.

L&D Training Committee: 
A Collaborative Approach to Continuous Improvement
One of the reasons for our success is the L&D Learning Committee, comprised of representatives from our member insurance companies. This committee meets quarterly to focus on current training issues and needs, creating a forum for open dialogue and shared insights. L&D monitors suggestions from the committee and incorporates them into our four-year plan to update and create training modules for both the NICTA on-demand catalog and the instructor-led FraudSmart® courses. This initiative is designed to keep our training modules in sync with the latest fraud trends and investigative methods.

Why This Matters

1. Relevance: Regular updates ensure that our courses stay relevant and provide value to our agents and partners.
2. Quality: The committee serves as a quality control mechanism, evaluating the efficacy of our training programs.
3. Expert Input: With representation from multiple insurance companies, the committee brings diverse expertise to the table, enriching our training programs.

Similar to the Learning Committee, L&D also engages with a Work Comp Focus Group on a quarterly basis to address the various issues associated with this type of fraud. This collaborative group played a pivotal role in the inception of NICB's Workers' Compensation Fraud Conference in 2020, which has since become an annual event.

The Work Comp Focus Group is an essential contributor to the planning of the annual conference. We draw inspiration for topics and speakers from this group, and often, one of its members will recommend a colleague as a potential speaker. Notably, the 2023 conference featured sessions led by SMEs from four different NICB member companies, all organizations that participate in the focus group.   

Recent Partnership Success Stories
One of the focus group members reminded us that claims reps are tasked with making quick compensability decisions. They need training that enables them to swiftly distinguish meritorious claims from those requiring closer scrutiny. However, these claims reps may not always have clearance for a full day of training. Fortunately, they might be able to allocate an hour for training on occasion. Our virtual Work Comp Wednesday special sessions were born from this observation.

We also leveraged our partnership with the Verisk training team to identify an excellent presenter to kick off the series in September. Bo Barber, director of investigative analysis at Verisk, presented “ClaimSearch Solutions in Work Comp Claim Investigations.” This was followed by NICB agents Chris Kluz and Sean Moore facilitating the two-part Premium Fraud FraudSmart course in October. In November, guest speaker Chryseis Starros of the San Diego County District Attorney’s Office presented a “Claimant Fraud Overview.”

The very first in-person Workers’ Compensation Fraud Conference held last October was co-sponsored by State Compensation Insurance Fund CA, another active focus group participant. Their corporate learning center in Vacaville, California, was the ideal location for this event. State Fund graciously provided access to their state-of-the-art Learning Center and supported NICB throughout the planning process and during the live event. Their assistance included valuable connections with other agencies, access to a state-of-the-art training facility, and exceptional on-site support staff.

The attendees were highly satisfied with the event, appreciating the diverse topics, excellent speakers, wonderful venue, and the networking opportunities.

Mutual Benefits

1. Increased Effectiveness: The conference was a platform for sharing current trends and best practices, leading to more effective fraud investigations.
2. Strengthened Networks: This event enabled both parties to expand their professional networks, which can lead to future collaborations.
3. Cost Savings: By utilizing the state agency’s facilities and staff, we could hold a high-impact event without incurring exorbitant costs.

The success of the Workers’ Compensation Fraud Conference underscores the potential of what can be achieved when entities collaborate for a common goal. NICB’s L&D is committed to nurturing these partnerships and the ongoing improvement of our training resources to further the fight against insurance fraud.