Results driven executive relied upon for claim/legal expertise, process analysis/redesign, critical decision making, recovery lawsuits, investigation coordination, training and to identify, investigate, prosecute & deter fraud. Uses business intelligence & analytical skills to confidently make successful decisions. |
Extensive Personal, Property & Casualty experience spending the past 12 of my 20 years in the Special Investigations Unit (SIU). My latest role as Executive has combined all of my experiences and accomplishments to make me a heavily relied upon individual to make successful critical decisions.
Although my primary experience has been in Insurance, my abilities to quickly learn, adapt, make decisions based on objective criteria, effectively communicate and execute plans allows me to be open to a possible career change into any environment.
As Executive, my role is to identify, investigate, prosecute and deter fraud. Responsibilities include:
Identify patterns and trends in staged automobile accidents, Medical Providers and Attorneys who represent injured parties;
Effectively communicate results to management to help determine which investigations will be viable; communicate through e-mail to multiple levels of employees on specific claim handling issues;
Thoroughly investigate identified patterns and trends using objective criteria and reserving judgment until investigation is completed;
Lead groups of investigators, attorneys, Law Enforcement and other personnel through successful investigations;
Liaison to Law Enforcement (NYPD Fraudulent Accident Investigation Squad FAIS, FBI, NYS Attorney General, District Attorneys, National Insurance Crime Bureau NICB) to provide training on Insurance Policy terms & conditions, training on Insurance Fraud, provide specific claim information through proper channels and advise on specific issues that lead to successful prosecutions;
Liaison to company attorneys to develop strategies for investigations at all levels, strategies for restitution lawsuits initiated by company and strategies for lawsuit defenses against company on an individual claim basis, group claims & class action lawsuits;
Provide expert testimony in Grand Jury hearings and provide defense affidavits & testimony in lawsuits against company on individual claims;
Train new employees in SIU on identification and investigation techniques;
Liaison to non-SIU offices to conduct general training in Fraud Awareness, increase referral rate, role of SIU and success stories;
Accomplishments cannot be disclosed over the internet due to confidentiality reasons but will gladly discuss with serious inquiries. |
