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2 months ago

Coalition Against Insurance Fraud: Texas Supreme Court Urged To Let Insurers Prove Fraud

Allowing medical providers to hide false claims amid treatment for crash injuries will encourage scams and could discourage insurers from writing business in Texas, the Coalition Against Insurance Fraud says in an amicus brief filed this week with the state Supreme Court.

“Medical providers will remain unjustly enriched and costs will be shifted to not only insurers, but those least-equipped to bear them: policyholders and claimants,” the Coalition says in a brief filed in the case of Allstate v. Rehab Alliance.

The insurer alleges Houston-based Rehab Alliance recruited legitimate crash victims for false injury treatment. The clinic upcoded treatment, billed doctor rates for work by nurses, and performed unneeded treatment such as MRIs, the insurer asserts. Patients also were secretly told they weren’t financially liable for uninsured treatment, Allstate says.

The insurer paid 107 claims and sued to recover after discovering evidence of fraud. A lower court granted Rehab Alliance summary judgement. Allstate appealed to the Texas Supreme Court. 

Rehab Alliance is the changing face of bogus crash-treatment claims, the Coalition says in urging the Supreme Court to send the case back for rehearing by the lower court. 

The clinic camouflaged false treatment claims involving legitimate crash injuries. Unlike staged wrecks with fake injuries, this sophisticated disguise makes it daunting to clearly separate bogus from necessary treatment claims.

“The fact that fraud in a particular claim is difficult to detect or quantify does not mean it should be allowed to be perpetuated. The result would be rewarding and encouraging agents of fraud,” the Coalition contends.

Insurers need access to civil courts and the ability to sue fraudsters. Allowing camouflaged injury claims burdens insurers with higher costs that raise premiums. Medical care and the ability of insurers to promptly settle claims will suffer as well.

“If this opportunity to help reverse the tide of soft fraud by medical practitioners is not taken, this kind of fraud will continue to occur. Further, the amount paid for fraudulent claims will increase,” the Coalition says.

Texas will become a haven for such schemes, potentially driving insurers out of the state. Patient care also could suffer from bogus treatment unrelated to healing their crash injuries.

If Texas cannot provide assurance to insurers and policyholders they are willing to take an effective stance against fraud, insurers become dis-incentivized to maintain large presences in the state, deploy effective anti-fraud measures there and, perhaps, even continue doing business there,” the Coalition says. 

The Coalition Against Insurance Fraud is a national alliance of consumer groups, insurers and government agencies combating all forms of insurance fraud.

5 months ago

The benefits of investing in commercial property by Bacall Development

Safety is the main reason why some people invest in commercial property since it's the main interest of many. Based on recent reviews, commercial property will still perform for you even if the economy slows down, unlike in residential property. And when the economy is strong, commercial property increases its value and gives you a stable income.

But if you're still in doubt or just planning to start out in this venture, Bacall Development explains the benefits you can gain from investing in commercial property through the following paragraphs to help you make up your mind. The firm is a full-service commercial real estate company that has been involved in this field for decades. 

Strong returns are not a surprise to some when it comes to commercial property. You can gain both income and capital growth in a commercial property since it provides strong and reliable returns. However, making a quick gain shouldn't be your only objective because this endeavor requires great effort and patience. You should take advantage of a growing investment over time where you can get a return consistently above inflation.

Aside from higher returns, commercial property is oftentimes more secure - a crucial point to others that can result in a steady income. Leasing commercial real estate usually ranges from three to ten years as opposed to short-term leases of residential properties.

Because of the mentioned benefits above, reviews state that the risk is lesser if you invest in commercial property than in residential property or the stock market. This data is based on overall analysis of both properties. 

According to Bacall Development and its associates, commercial property can catch the attention of different sectors in the economy. Because of the dependence of retail property on consumer spending trends, it has the highest direct relationship to the economy, along with industrial properties. Office buildings are most likely to perform depending on long-term supply and demand. Exposure to various sectors can deliver great benefits to you and to avoid fraud as well.

Acquiring tax benefits is imaginable with a commercial property. Most commercial properties attract handy building allowances as well as depreciation allowances on plant equipment within the building.

Protection against inflation is also one of the benefits of investing in commercial property. Reviews reveal that commercial property has been considered as a good protection against inflation over the years. It has a good record of outpacing inflation over a long period of time.

Investment control? Yes, it's possible. You have a significant level of control over your investment in case you're an owner of a direct property. You have control on various areas such as change of use for the property, disposal, redevelopment, renovations, the terms of the lease, the type of tenant, and upgrading.

Furthermore, you have the ability to add value in a commercial property investment through improvement of the appearance, renovation, lease restructure, subdivision or enlargement, and upgrade. You can further leverage your commercial investments as you improve the property and it grows in value. By borrowing more against your improved equity, you can quickly be in a position to control a sizeable portfolio of properties. 

However, Bacall Development needs you to know that there are still disadvantages in owning commercial properties. What are mentioned above could be the total opposite to others based on their individual experience. The firm suggests that you must choose the right commercial property to have a strong capital growth and gain a great rental return. You must know what makes a good commercial property.

5 months ago

International Organization of Securities Commissions

Background

The International Organization of Securities Commissions (IOSCO) is the worldwide association of national securities regulatory commissions, such as the Securities and Exchange Commission in the United States, the Financial Services Authority in the United Kingdom, and about 100 other similar bodies. 

The member agencies of IOSCO have agreed to:

•    cooperate in developing, implementing and promoting adherence to internationally recognised and consistent standards of regulation, oversight and enforcement in order to protect investors, maintain fair, efficient and transparent markets, and seek to address systemic risks
•    enhance investor protection and promote investor confidence in the integrity of securities markets, through strengthened information exchange and cooperation in enforcement against misconduct and in supervision of markets and market intermediaries
•    exchange information at both global and regional levels on their respective experiences in order to assist the development of markets, strengthen market infrastructure and implement appropriate regulation.
•    Under the Multilateral Memorandum of Understanding Concerning Consultation and Cooperation and the Exchange of Information, member organisations cooperate with each other in matters of enforcement.

IOSCO's involvement in IFRS

IOSCO's enforcement role extends to matters of interpretation of IFRS, where IOSCO maintains a (confidential) database of enforcement actions taken by member agencies.

In September 2013, IOSCO and the IFRS Foundation announced agreement on a set of protocols to improve consistency in the implementation of IFRS. The Statement of Protocols for Cooperation on International Financial Reporting Standards reiterates the current relationship between the two organisations, and identifies four new areas for mutually supportive work:

•    Use of IFRSs within jurisdictions around the world — IOSCO and the IFRS Foundation will periodically share information to maintain current and accurate data on the progress of global IFRS adoption
•    How securities regulators will be affected by IASB standards — The IFRS Foundation will identify and explain implementation aspects of the IASB’s new or significantly amended standards that are of interest to securities regulators
•    Discussion of IFRS enforcement matters — IOSCO will organise an annual IFRS enforcers’ discussion session for its members to discuss issues, standards and other IFRS enforcement matters with IASB members or staff
•    Providing critical and timely input — The IFRS Foundation will solicit IOSCO member opinions on any time-sensitive IFRS implementation matters needing urgent input from securities regulators.

6 months ago

Global Director - Fraud Detection and Analytics

JCW is currently working on an exciting retained search for a Global Director of Fraud Detection and Analytics at a rapidly growing Payments Organization. The qualified candidate will help to develop a pre-existing fraud detection system, with cutting-edge mitigation solutions in place - but also to develop the scope of this system to a global level leading the Fraud team in both the EU and US. This position will be based in Stockholm, Sweden and full relocation benefits will be offered.

Responsibilities include:

•    All end customer fraud prevention efforts across the organization’s rapidly expanding, multi-country footprint
•    Overseeing fraud analytics and development of the fraud detection system
•    Continuous gap and root cause analysis to improve fraud and underwriting decisions
•    End-to-end development of fraud prevention strategies
•    Overall leadership in innovating, building, and implementing fraud risk solutions and setting the roadmap of external and internal fraud prevention tools
•    Creating and maintaining metrics for measuring the success of fraud systems and agents
•    Owning and resolving all fraud related issues related to geographic expansion and new verticals
•    Communications on fraud topics to the executive management team
 
Position requirements:

•    Extensive leadership experience with a pragmatic approach to motivating teams.
•    Large scale Fraud Prevention experience with a global firm
•    The ability to lead teams and influence senior management on a global scale
•    An understanding of payments methods and the internet retail ecosystem.
 
Et Halstead recruits for Fraud and Risk professionals across the financial services sector and would be happy to provide further details about this or other positions. You can reach him at 646-934-8400 or at Et.Halstead@jcwresourcing.com

6 months ago

Cybersecurity Fraud Intelligence Lead: Vice President

The Cybersecurity organization's objective is to ensure that JPMC is able to effectively detect, prevent, and respond to cyber threats against our technology infrastructure. The scope of Cybersecurity comprises detection and monitoring of threats and vulnerabilities, managing security incidents, and evolving our preventive infrastructure to keep ahead of the threat. We accomplish this through strong information security leadership and active collaboration with line of business information risk managers to provide high quality security solutions and services that are focused on improving the Firm's risk posture. 

The Cyber Fraud APAC and South America Lead will work closely with Fraud Intelligence teams within Cyber Security Operations to maintain and advance intelligence collection efforts, optimize reporting, and manage metrics production. 

Responsibilities:

•    Lead efforts across Fraud Intelligence teams (card, banking, data automation) to expand the teams' intelligence collection, optimize reporting to internal stakeholders, and assist in managing expanding metrics production efforts specific to the Asia Pacific and South American geographic areas
•    Act as the Fraud Intelligence lead representative in a multi-disciplinary security operations center (SOC)
•    Act as liaison between Corporate Cyber Security Operations-Fraud Intelligence and the various JPMC lines of business (LOBs)
•    Work closely with Cyber Security Operations teams to collaborate on a first in class intelligence program.
•    Maintain and advance knowledge of industry fraud trends
•    Conduct and manage detailed analysis and risk assessments on all issues affecting the Firm
•    Engage in problem solving, process improvement, and strategic planning initiatives
•    Continually identify and evaluate 3 rd party solutions to fraud problems facing the Firm
•    Author and edit intelligence reports and contribute to metrics production

Qualifications

5+ years of experience with at least 3 collecting and analyzing intelligence, conducting financial investigations, and/or working in banking technology, risk, or operations including APAC and South America 

•    3+ years of experience collecting and analyzing intelligence, conducting financial investigations, and writing professional reports
•    Experience with large volumes of transactional data, conducting deep-dive analysis, and financial services industry products and services
•    Experience serving business stakeholders, managing cross collaboration, and leading teams
•    Strong knowledge of banking terms, phrases, and concepts
•    Prior cyber security and/or cyber threat experience a plus
•    The ability to work in a fast paced environment to include the translation of complex concepts and issues into messaging easily understood by senior leadership
•    Bachelor's degree or equivalent experience
•    Prior threat intelligence/SOC experience a plus

People Skills:

•    Excellent people, time management, and organization skills
•    An ability to work with minimal direction and supervision-independently or in leadership role
•    Experience managing aggressive deadlines in a fast-paced environment
•    The ability to coordinate, work with, and gain the trust of business stakeholders to achieve a desired objective

1 year ago

IGC & Associates, Inc.

IGC & Associates, Inc: Bridging the Gap- Engaging Generational Differences

So what is all this generational talk all about? Slackers, Tech Savvy, lazy, "pay their dues!", text / IM, fear of change, respectful, job-hoppers, Social Media, lack of loyalty …sound familiar? Today, in most companies, your workforce demographics may include workers from all generations: Traditionalists, Baby Boomers, Generation X, and Millennials. We work with organizations and individuals who are working to increase their awareness and overcome the challenges they face with variety of generations in today’s workforce.