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A brand new designation has been created for claims and claims related professionals out of a partnership between the Employers’ Fraud Task Force and the Insurance Educational Association.    It’s a CPFI, which stands for Certified Professional in Fraud Identification. 

To achieve a CPFI designation, one needs to take 3 specific courses.

These courses are:  1. Foundations in Fraud Identification, 2. Essentials in Workers’ Compensation Fraud Identification, 3. Advanced Issues in Workers’ Compensation Fraud Identification. 

Foundations in Fraud Identification lays out the basics as to how fraud affects businesses, governments, and individuals.  It delivers a basic understanding of fraud along with the types of fraud.   It teaches basic investigations along with preservation of evidence.

Some of the areas covered are fraud schemes; employee embezzlement fraud triangle; payment , delivery receipt and price fraud; and contract rigging schemes.

Essentials in Workers’ Compensation Fraud Identification explores different types of workers’ compensation fraud and highlights the investigative tools utilized by insurance companies and self-insureds.  The course development partner with IEA for this course is the Employers’ Fraud Task Force.

Some of the areas covered in this course are the various forms of claimant fraud, medical fraud, prescription drug fraud, insider/professional fraud of claims handler, broker or attorney.  It teaches the creation of a culture of zero tolerance for fraud in the workplace with employer-level and carrier-level investigation activities.

Advanced Issues in Workers’ Compensation Fraud looks at the advanced issues facing the industry.   The development partner with IEA is again the Employers’ Fraud Task Force. 

This course covers Special Investigations Units, identifying fraud through technology, social media investigations, investigator standards of conduct, field investigation activities, privacy issue, choosing an investigative firm, and avoiding bad faith.

These courses for achieving this CPFI Designation can be taken from home, office, or even from a Starbucks, if desired.  One needs a cell phone or a land line telephone, as the instructor led classroom is done over the phone in a conference call with all the students enrolled and the instructor.  The IEA website provides additional course materials and the place to take the exams.   Any company or group can also specially arrange to have this class taught by an instructor in person at a location.

The industry expert instructors are Diana Henderson, ARM, CPDM, WCCP and Don Dodson, ARM, CPDM, COSS.  Some invited guest lecturers include representatives from the California Department of Insurance Fraud Division, representatives from the District Attorney’s office in Orange County, representatives from the law firm of Floyd, Skeren and Kelly, Michael Goodman, owner of ICU Investigations, John Standish, the owner of The John Standish Consulting Group, and Stacey Golden, the Director of Claims/SIU Keenan & Associates.

For any questions, help, further amplification, or to arrange a group class at a location, Patty Gibson Carlson, IEA Director of Sales, can be contacted at patty@ieatraining.com and at 714 689-0161. 

lonce@adjustercom.com