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Smith: Working Closer, Stronger, Better

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The COVID-19 pandemic has inflicted vast damage across our nation and the globe. Especially heartbreaking is the large loss of human life.

Matthew J. Smith

Matthew J. Smith

When I was a young boy, my grandfather repeatedly instilled in me, “From all bad comes good.” I’m now 62 years old and have seen firsthand the truth behind his words. So what possible good will we in the anti-fraud community derive from this virus?

On March 31, something occurred that has never taken place: The largest gathering of fraud fighters in U.S. history.

Scarcely a week before, the coalition launched the idea of a national webinar to address COVID-19 insurance fraud. We invited our partners at the National Insurance Crime Bureau and the International Association of Special Investigation Units to join with us. In that short week, more than 3,000 fraud fighters rallied to join this urgent information-sharing video session.

Even our best-attended anti-fraud events have never seen so many professionals gather at one time. This underscores the serious risk of insurance fraud that COVID-19 threatens. It also reinforces the incredible dedication of anti-fraud professionals to protecting our nation from schemes and scams.

Equally, we’re learning how vital it is to share information among everyone in the fraud fight. For much too long, I’ve heard insurers adamantly refusing to voluntarily share fraud information with state regulators. Their reluctance is based partially on bad experiences and on the assumption or fear the “other side” has some nefarious purpose.

Regulators also share blame. The schism deepens from often “heavy-handed” approaches or seeking to “balance the scale” through more onerous fraud reporting requirements. I have spent more than three decades having the privilege to work with insurers and regulators. The overwhelming majority — well above 90% — are good, honest and decent.

Yet the lack of cooperation too often occurs from lack of trust and understanding. Perhaps the need to unify against COVID-19 fraud is a good reminder that insurers and regulators exist for one reason: to protect consumers in their times of greatest need. We may not all agree all the time. But let us pledge in this crisis to do a better job working together for the common good.

All of us also are learning new ways to perform our anti-fraud roles. I have seen more state insurance departments push out anti-fraud information than I can ever remember. It’s a very good thing.

Insurers moved with incredible speed to have entire claims teams, investigators and leaders work remotely. There has probably never been such a shift of workplace dynamics in insurance history. We may be witnessing the start of the “techno-industrial revolution” right before our eyes.

Attorneys are conducting examinations under oath for the first time by videoconference. Investigators are conducting interviews and even documenting injuries via photo and video, which normally are observed in person.

Smartphones are being used to “inspect” auto and property damage claims. At least several state insurance departments have set up online programs to collect reports of COVID-19 scams and refer credible reports to prosecutors or the attorney general for immediate action to protect consumers. Some of these “changes” may be short-term once this crisis passes. Others may show us new and better ways to improve the fraud fight for decades to come.

Finally, a note of thanks. Since our founding in 1993, the Coalition Against Insurance Fraud has stood and partnered with our great allies IASIU and NICB.

When planning for this record-setting webinar began, we reached out first to Joe Wehrle, CEO of the NICB, and Dallas Barnes, IASIU president, to seek their support. Without hesitation, both immediately voiced their support and pledged their organizations’ skills, resources and teams to make this the webinar succeed. Joining together for the first time in history, more than 3,000 anti-fraud professionals became a team. The coalition, IASIU and NICB worked together to form that team.

May our working together as partners achieve ever more success in the years ahead. Just as important, may we stand as a model for all fraud fighters to work together and even better-protect American citizens from the perils of insurance fraud.

Matthew J. Smith is executive director of the Coalition Against Insurance Fraud. This column is republished with permission.

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Dr Apr 11, 2020 a 6:04 am PDT

Compare "Covid 19: Is Marketing in Health Care taking Precedence over Safety?" -- The Weinmann Report, www.politicsofhealthcare.com, 10 April 2020. -- Robert L.
Weinmann, MD, QME, Editor

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