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Major Case Investigations: Medical Fraud

Curriculum: Special Investigations/Fraud

Monday, March 20 — 1:30 - 3:00
Tuesday, March 21 — 3:30 - 5:00

Matthew Gray, Claim Investigation Consultant, Grange Insurance, Columbus, OH
Chris Phillips, FCLS, Claims Investigator, Grange Insurance, Lehigh Valley, PA

  • Identify proper candidates for medical Major Case investigations
  • Identify and mitigate fraudulent medical billing
  • Develop fair and objective negotiation skills
  • Build and maintain an intelligence database

Measuring Business Income Losses: Emerging Issues

Curriculum: Commercial Time Element Losses

Tuesday, March 21 — 10:30 - 12:00
Wednesday, March 22 — 1:30 - 3:00

James V. Chin, JD, Partner, Zelle LLP, Atlanta, GA
Glenn Ricciardelli, CPA, CVA, CFE, CFF, Partner, MDD Forensic Accountants, Boston, MA
Joseph Slane, RPA, Sr. EGA, EVP-Specialty Loss Group, Engle Martin, Wayne, PA

  • Identify the challenges in projecting a business’ financial performance as we slowly move beyond the COVID-19 pandemic
  • Assess the impact of the supply side constraints in the economy, including extensions of the period of restoration
  • Describe the impact of the return of inflation on loss measurements after experiencing a long period of “cheap money”
  • Compare the current constraints in the supply of labor affecting business performance in terms of output and cost

Mediation Techniques & Strategies that Work

Curriculum: Alternate Dispute Resolution

Monday, March 20 — 10:30 - 12:00
Tuesday, March 21 — 3:30 - 5:00

Michael Pritchett, AIC, Sr. Claims Specialist, Cypress Group Holdings, Inc., Helotes, TX
Andy Rock, JD, Partner, The Rock Law Group, P.A., Maitland, FL
Claire Winston, JD, Director-Claims Litigation, GeoVera U.S. Insurance Group, Fairfield, CA

  • Describe optimal strategies to employ when preparing for a mediation
  • Identify qualities that contribute to a successful mediation
  • Demonstrate persuasive presentation techniques to enhance negotiation leverage
  • Evaluate steps to take to conclude mediation with enforceable settlements

Misrepresentations: Coverage Considerations

Curriculum: Special Investigations/Fraud

Monday, March 20 — 1:30 - 3:00
Tuesday, March 21 — 1:30 - 3:00

Kelly Parkhurst, Senior Claims Specialist, Great American P&C Group, Cincinnati, OH
Richard I. Woolf, JD, Partner, Baker Sterchi Cowden & Rice, St. Louis, MO

  • Recognize fact scenarios giving rise to misrepresentations in the application and claim investigation
  • Identify coverage issues that arise when facts appear inconsistent with what was initially presented by the insured
  • Apply coverage principles to various fact scenarios to better address apparent misrepresentations in an application or claim

Mock Mediation & Strategies for Casualty Adjusters

Curriculum: Casualty Campus

Monday, March 20 — 3:30 - 5:00
Tuesday, March 21 — 10:30 - 12:00

Rina Carmel, JD, Senior Counsel, Anderson McPharlin & Connors, Los Angeles, CA
Jeff Kichaven, JD, Independent Mediator, Jeff Kichaven Comm'l Mediation, Los Angeles, CA
Rebekah Ratliff, CCLS, Mediator/Arbitrator, JAMS, Atlanta, GA

  • Analyze how coverage issues impact settlement of liability claims
  • Develop strategies for negotiating settlement in multi-claimant, multi-insured situations
  • Compare negotiating strategies employed by coverage counsel, a mediator, a policyholder-side lawyer, and plaintiff’s counsel
  • Describe ethical considerations that insurers and their counsel may face at mediation

Motorized Vehicles: Liability & Coverage Issues

Curriculum: Casualty Campus

Tuesday, March 21 — 1:30 - 3:00
Wednesday, March 22 — 3:30 - 5:00

Patrick D. Cloud, JD, Shareholder, Heyl, Royster, Voelker & Allen, Edwardsville, IL

  • Identify the types of policies that may be implicated in these accidents, including policies for off-road vehicle insurance, personal automobile, homeowners, umbrella, commercial general liability, and commercial auto
  • Evaluate the coverages provided by these policies, including whether these accidents trigger the insuring agreements of these policies and whether the accidents otherwise fall within an exclusion
  • Prepare a plan to advance and preserve liability coverage defenses, including the possibility of the appointment of independent counsel
  • Assess the potential implication of uninsured motorist coverage, underinsured motorist coverage, and medical payments coverage

Multiple Claimants & Insufficient Policy Limits

Curriculum: Casualty Campus

Tuesday, March 21 — 10:30 - 12:00
Wednesday, March 22 — 8:30 - 10:00

Kathy J. Maus, JD, Partner, Butler Weihmuller Katz Craig, Tallahassee, FL
Julia Molander, JD, Insurance Lit. Consultant, JAMolander Consulting, San Francisco, CA

  • Describe the issues involved where multiple claimants seek compensation under a policy or policies with insufficient limit
  • Survey the statutes and cases that may apply to multiple claimants or multiple insureds with insufficient limits
  • Identify hot spots and predicaments that pose potential exposure to bad faith liability because of insufficient limits
  • Develop practical approaches to handling claims in situations presenting insufficient limits


We hope you will join us in Orlando for 3 days of expanding your story as a claims professional.

  • WRITE YOUR OWN AGENDA from over 100 educational sessions within 14 tracks taught by industry leaders
  • EXPAND YOUR NETWORK by telling your story as a claims professional and hearing the stories of a diverse range of claims professionals
  • PREPARE FOR YOUR NEXT CHAPTER by making connections with a broad, innovative group of the industry's leading service providers at the Insurance Services Expo

It was my first time, so it was a great time hearing from a lot of different people and experiencing something new.

I like there are educated speakers who show genuine appreciation and passion for their topics.

I enjoyed the variety of sessions and the networking promoted within the session. I alsoappreciated the collection of exhibitors that had various ways of engagement.

The Networking was amazing, but just being able to be together with peers and new friendsagain was so needed!

I enjoyed meeting other professionals in the business. I also loved the various topics andhearing how other insurance carriers were addressing some of the same issues we encounter.

The informational sessions were very useful and gave me a lot of great things to bring backwith me.

The variety of content and the sessions that were interactive. So valuable to learn from otherattendees and how they tackle challenges and issues at their organizations.

Opportunity to connect with other claim professionals and vendors. Informative & interestingpresentations. Appreciated that a lot of the presentations qualified for CE credit.

PLRB greatly appreciates the following claims service providers for their outstanding support for the 2023 Claims Conference.


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