Casualty Actuarial Society

Professional Education

Tightening the Noose: Innovations in Claim Fraud Detection Webinar

A CAS Webinar

Tuesday May 10, 2011
1:00 -2:30pm EDT

  

Session Description

Claims payments and processing costs consume nearly 80 percent of insurance premiums. It is estimated that fraudulent claims account for a sizeable portion of these payments. This session will discuss new ways to expedite payment of meritorious claims and detect fraudulent ones, and the latest advances in predictive analytics, text mining, and network data analysis and visualization.

Intended Audience

CAS Members and Non-Members are welcome to attend. This session may be of particular interest to those actuaries who would like to explore predictive analytics as a tool to assist in detecting fraudulent claims. Additionally this session will be of interest to claims and special investigative units.

Presenters

Karthik Balakrishnan, Ph.D., Vice President, Analytics, ISO Innovative Analytics

Dr. Karthik Balakrishnan has more than 15 years of experience in building learning systems and predictive models for challenging problems in both industry and academia. He has published more than 20 papers on neural computation, evolutionary algorithms, and neuro-cognitive modeling, and is the coauthor of an MIT Press book on evolutionary synthesis of intelligent agents. He is a strong proponent of the "toolkit" approach — leveraging multiple modeling and analysis methodologies to craft pragmatic solutions. In his current role, Dr. Balakrishnan oversees all predictive analytics initiatives at IIA, including property/casualty and mortgage fraud analytics.

Dr. Balakrishnan has more than nine years of predictive modeling experience in property/casualty insurance, building and directing the development of solutions for marketing (customer segmentation, channel/producer segmentation, opportunity scoring), underwriting/pricing (personal auto, homeowners), and operations (claim fraud detection, subrogation identification, premium audit prediction). He has also managed data warehousing and direct mail/marketing functions at several companies. He began his career at Allstate Research and Planning Center and led analytics organizations at Obongo (a subsidiary of AOL) and Fireman's Fund Insurance Company. He has been with IIA since June 2007.

Thomas Mulvey, National Director, SIU and Claim Services, ISO

Thomas Mulvey has been in the business of insurance investigations for more than 27 years. In his current position, he serves ISO as the national director of SIU and claim services. He is also the coordinator of ISO’s Insurance Fraud Management Conference. Before joining ISO, Mr. Mulvey was the national SIU director for the Prudential Property & Casualty Insurance Company. He also had responsibilities in the area of corporate investigations as a director at Prudential in their worldwide operations.

Mr. Mulvey has authored numerous state antifraud plans, SIU operational manuals, industry “best practice” studies, and SIU-related articles for trade periodicals. He has also served as a police and fire academy trainer and has been a frequent presenter at international, national, and regional antifraud conferences and seminars.

Mr. Mulvey is a graduate of Providence College and holds a master’s degree in criminal justice administration. He has also held the designations of Certified Insurance Fraud Investigator and Certified Fraud Examiner.

Mr. Mulvey is an active member of the New Jersey Special Investigator’s Association. He has served on committees and working groups with the Coalition Against Insurance Fraud, the National Insurance Crime Bureau, the C-COR SIU Committee, and the New Jersey Office of the Insurance Fraud Prosecutor.

Registration Information and Fees

  
Registration Fees (U.S. Dollars) Received by
May 2, 2011
Received on/after
May 2, 2011
Individual Registration $50 $75
Multiple Registration*
Multiple registrations must use the same computer and telephone connection.
$250 $300

*Multiple Registrations may provide a list of attendees to the CAS via email, meetings@casact.org so CAS may note attendance for all participants in their CAS member record.

Cancelations/Refunds

Registrations fees will be refunded for cancellations received in writing at the CAS Office via fax, 703-276-3108, or email, refund@casact.org, by May 3, 2011 less a $25 processing fee.

CAS Continuing Education Policy

The CAS Continuing Education Policy applies to all ACAS and FCAS members who provide actuarial services. Actuarial services are defined in the CAS Code of Professional Conduct as “professional services provided to a Principal by an individual acting in the capacity of an actuary. Such services include the rendering of advice, recommendations, findings, or opinions based upon actuarial considerations.” Members who are or could be subject to the continuing education requirements of a national actuarial organization can meet the requirements of the CAS Continuing Education Policy by satisfying the continuing education requirements established by a national actuarial organization recognized by the Policy.

This activity may qualify for up to 1.5* CE Credits for the Spring Meeting for CAS members. Participants should claim credit commensurate with the extent of their participation in the activity. CAS members earn 1 CE Credit per 50 minutes of educational session time not to include breaks or lunch.

*The amount of CE credit that can be earned for participating in this activity must be assessed by the individual attendee. It also may be different for individuals who are subject to the requirements of organizations other than the American Academy of Actuaries.

 

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