Annual Central Ohio Insurance Education Day Joe Wehrle, President & CEO April 6, Insurance Fraud: A Growing Concern for Everyone

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1 Annual Central Ohio Insurance Education Day Joe Wehrle, President & CEO April 6, 2011 Insurance Fraud: A Growing Concern for Everyone

2 NICB Disciplines Data Analytics Investigations Training Legislative Advocacy Public Awareness

3 NICB Business Model Place text, bullets, photos, etc., here beneath line

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5 $30 Billion Per Year Industry estimates that fraud against property and casualty insurers cost Americans $30 billion per year or in other words: $82.2 million a day $3.4 million an hour $57 thousand a minute $951 a second

6 Information Sharing Vital to fight fraud Speed and timeliness of files to NICB NICB familiar with the differing jurisdictional requirements of Law Enforcement

7 Investigations

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9 Priorities Medical Fraud Commercial Fraud Vehicle Crime

10 Prosecutive Administrative Actions Successful criminal prosecution Court-ordered restitution Sanctions by professional certification boards Indictments Warrants Arrests

11 Medical Fraud 1, Medical Related PAAs

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13 2010 Medical Fraud Trends Questionable Claim Referrals Indicate: 40% of the total Casualty Referral Reasons are allegations of wrongdoing by the medical provider Duplicate Billing Excessive Treatment Provider/ Facility Improperly Licensed Billing for Services Not Rendered Solicitation Inflated Billing Unbundling/ Upcoding

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16 Commercial Fraud Specialized Equipment Cargo Theft Slip and Fall Rings

17 Commercial Fraud ,576 1, , Commercial Related PAAs

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19 Cargo Theft January FBI announced Cargo Theft data element has been adopted in the National UCR Program - Next steps - 18 to 24 months for State UCR Programs to implement software changes Co-Chair the National Cargo Theft Task Force - National Cargo Theft Summit, 10/20/2010, Washington D.C. - Organizing follow-up meetings on U.S. Capitol Hill Partnered with ISO to design CargoNet, a data network that will improve information sharing between insurers, transportation companies and law enforcement

20 Cargo & Heavy Equipment Solutions Provide law enforcement training to police departments specific to cargo theft Expand U.S./Mexico treaty to include Heavy Equipment and Marine Vessels Utilize CargoNet Theft Reporting, Deterrence and Analytics

21 Vehicle Crime Vehicle Recovery Repatriation Vehicle Inspection Organized Vehicle Crime

22 Vehicle Recoveries 25,000 20,000 17,628 20,355 20,459 18,275 15,000 14,754 10,000 5,

23 Organized Vehicle Crime Organized Vehicle Crime Related PAAs

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26 Training

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28 Legislative Advocacy

29 Key Issues Stronger anti-fraud laws Immunity Dedicated prosecutors Statewide insurance fraud & vehicle theft summits National and state insurance trade group coordination Liaison to NAIC Anti-Fraud Task Force - Fraud Bureau Reporting, via NAIC, NICB, ISO

30 National Health Care Reform How does Health Care Reform impact property/casualty insurance?

31 Health Care Fraud Sophisticated enterprise Attacks both public and private to include P&C Criminal conspiracies do not discriminate Organized Medical Fraud Rings in health care, property/casualty insurance and government programs see no firewalls Some companies and industry are risk averse Take advantage of the fact we are reluctant to share information Huge dollar losses continue to grow and fraud is rampant

32 Anti-Fraud Recommendations Health Care Reform A dedicated federal staff to execute a national anti-fraud program in conjunction with state and local law enforcement An increase in prosecutorial and investigative resources to fight fraud* Strong and effective criminal penalties* Expansion of database technologies to improve fraud detection* Litigation protection for citizens and organizations that provide information or otherwise cooperate with the anti-fraud program Creation of a public-private partnership centered around an organizational mechanism (Council) to guide anti-fraud strategy * Mentioned in health care legislation

33 Next Steps Weekly teleconferences with HHS/CMS Focus on Regional Health Care Fraud Summits Create a public/private partnership to guide anti-fraud strategy as noted by HHS Secretary Sebelius and Attorney General Holder in numerous public announcements Formalize agreement to share data between public and private sectors Keep the anti-fraud effort entirely bi-partisan

34 National Motor Vehicle Title Information System (NMVTIS) Electronic title verification system, via DMVs Designed to protect consumers from fraud and unsafe vehicles Keep stolen vehicles from being resold NICB NMVTIS Federal Advisory Committee

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36 Public Awareness

37 Public Awareness Hot Wheels Vehicle Theft Statistics Ten Most Stolen in United States: Honda Accord Honda Civic Toyota Camry Ford F-150 Pickup Dodge Ram Pickup Dodge Caravan Chevrolet Pickup (Full Size) Acura Integra Ford Explorer Toyota Corolla

38 NICB VINCheck

39 Awareness Campaigns Tampa, Florida

40 Houston Billboard

41 Atlanta Billboard

42 Final Thoughts In a Weakening Economy... The professional thieves become more aggressive Some citizens are looking at insurance fraud as an alternative to solve their financial problem

43 This is a protracted conflict & the enemy: outnumbers us is more flexible and nimble than we are is taking advantage of our weakness sees insurance fraud as easy money

44 WE HAVE A SHARED RESPONSIBILITY TO WIN THIS CONFLICT NICB, member companies, law enforcement, and anti-fraud organizations must present a united front to protect the American people and insurer investment.

45 Questions?