www.NJSIA.org
New Jersey Special Investigators Association, Inc.

2021 Workshops

(Subject to Change)

Honored Speaker


Matthew J. Smith, Esq. Executive Director, Coalition Against Insurance Fraud

logo

Matthew J. Smith, Esq.

Matthew is a respected anti-fraud professional. Under his leadership, the Coalition is bringing together our diverse members from all sectors of the fraud fight including consumer advocates, insurers, legislators, regulators, government agencies, prosecutors, law firms and respected business partners. 

Before joining the Coalition staff in 2018, Matthew founded one of the nation’s leading law firms specializing in handling of insurance fraud and bad faith cases. He previously served as our Director of Government Affairs and legal counsel. Matthew is a prolific writer and speaker who serves on many boards and committees related to fraud-fighting efforts.

Matthew graduated from the Salmon P. Chase College of Law and the University of Cincinnati College Conservatory of Music where he studied Radio, TV & Film.

 Matthew@insurancefraud.org


Workshops & Bios

(Subject to Change)

Automobile Finance Fraud

The New way to steal a car including social media driven underground vehicle rentals


Jarek Pryzanowski

This workshop will discuss Automobile Finance Fraud and how it has become the new way of stealing cars and how it relates to insurance fraud.  It will cover how New Jersey temporary registrations have become the link to all types of motor vehicle fraud, including insurance fraud. This workshop will also cover fraud related to social media driven underground vehicle rentals. 

Jarek Pyrzanowski

Lt. Jarek Pyrzanowski has been a member of the New Jersey Division of Criminal Justice, Insurance Fraud Prosecutor’s Office since February 2000.  Prior to joining DCJ/OIFP, Lt. Pyrzanowski worked in the Special Investigations Section of Liberty Mutual Insurance Company and as a Borough of Belmar Police Department patrol officer.  He is currently assigned to the New Jersey State Police, Auto Theft Task Force (ATTF), which is comprised of members of various law enforcement agencies tasked with investigating organized auto theft groups. Throughout his twenty-year law enforcement career, he has been assigned to various units that conduct complex investigations pertaining to automobile theft, financial crimes, criminal street gangs, drug trafficking and official misconduct.  Lt. Pyrzanowski possesses a Bachelor of Science degree in Criminal Justice from New Jersey City University.  Lt. Pyrzanowski is a certified technical investigator and has extensive knowledge of electronic surveillance techniques and tactics.  Lt. Pyrzanowski is also proficient in various cell phone forensics and vehicle infotainment extractionist.  Lt. Pyrzanowski has extensive experience investigating techniques and practices utilized by individuals to commit auto theft, automobile fraud and insurance fraud.  Lt. Pyrzanowski is the former President of the New Jersey Vehicle Theft Investigators Association and is currently on the board of directors of North East International Association of Auto Theft Investigators.  He regularly speaks at various Law Enforcement and industry seminars and is a frequent speaker at New Jersey Police Academies.  

Building Your Vehicle History to Build Your Case


Dennis J. Mignogno

This workshop will cover the following:

  • Researching vehicle history, written records and reports
    • Where to find
    • What to look for
    • How to understand and why it’s important
  • Relevant and effective questioning
  • Case studies and how this information applies to the case.

                             

NEFCO Fire Investigations

Direct:  973-617-6202

Submit Assignment: 800-675-8500

DENNIS J. MIGNOGNO.: NAFI/CFEI, NAFI/CVFI, CFII

Dennis Mignogno is a Certified Fire and Explosion Investigator, Certified Vehicle Fire Investigator, and Certified Fire Investigator Instructor through the National Association of Fire Investigators. Dennis has 31 years of experience in the fire service, including five years as a fire chief. He also has 20 years of experience in the field of automotive repair and 22 years of experience as a forensic examiner. Dennis has instructed many seminars across varied topics, including Vehicle Fire Investigation, Mechanical Failure, and Forensic Photography. He is a member in good standing of the National Association of Fire Investigators, the International Association of Arson investigations, and the International Association of Auto Theft Investigators. Dennis is also a Forensic Locksmith trained by the Associated Locksmiths of America. He has testified as an expert witness in both state and federal court.

Covid-19 Scams: Identifying and Combating Fraud Schemes During the Covid-19 Pandemic

                                                                                                                                                                          

This presentation will address fraud schemes associated with the Covid-19 pandemic, ranging from vaccine and healthcare fraud associated with testing and treatment of Covid-19, as well as unemployment and Cares Act fraud schemes.  We will identify these schemes and how they may impact our SIU investigations.


Michael Benjamin Gerstein

Michael Benjamin Gerstein is a member in the Philadelphia office of Bennett, Bricklin & Saltzburg LLC defending the firm's clients in a variety of personal injury, property damage and premises liability cases. He is a member of the Pennsylvania Bar and New Jersey Bar. Michael is an active trial attorney, having defended numerous jury trials in venues across the region including Philadelphia, Montgomery County, Bucks County and Delaware County.

Michael obtained his B.A. from Drexel University in 2004, graduating magna cum laude. While at Drexel, Michael studied history and political science and was awarded most distinguished seminar research paper by faculty. Michael spent his junior year abroad at the London School of Economics, achieving honors in the General Course program. After graduation, Michael managed a small legal services business in Philadelphia. He then attended Villanova University’s Charles Widger School of Law, graduating in 2009.

In the summer of 2008, and throughout his third year of law school, Michael clerked for the firm. During law school, he was an Executive Board member of the Villanova Law Moot Court Board, externed for the Honorable Mark I. Bernstein in the Philadelphia Court of Common Pleas of Pennsylvania, served as a teaching assistant and worked as a certified student attorney in the Villanova Civil Justice Clinic.

When he is not in the office, Michael enjoys spending time with his family and friends, reading, cycling and golfing.

Nicole V. Rossi

Nicole Rossi has been an associate with Bennett, Bricklin & Saltzburg, LLC, since December of 2019.  She is part of the firm’s Special Investigations and Fraud team, and is admitted to practice law in the courts in the states of Pennsylvania and New Jersey.  She earned her Juris Doctor from Rutgers Law School - Camden.  Prior to joining Bennett, Bricklin & Saltzburg, LLC, Nicole worked at a general practice firm in Oxford, PA, where she represented clients in a variety of matters including family law, DUIs, minor criminal matters, personal injury, estate planning, and real estate.


Digital Image Forensics               

The COVID-19 pandemic rapidly accelerated adoption of digital processes, with carriers increasingly using digital media to adjudicate claims remotely. Now, as we emerge from the pandemic, these processes are vital to carriers as they increasingly focus on claim automation and straight through processing.. However, using digital media in claims also elevates fraud risk. This session will explore how easy it is for fraudsters to submit fake photos and manipulated images with claims and new tools you can use to detect digital media fraud quickly and accurately.

Josh Louwagie

Matt Frei                                                                                  

Josh Louwagie

Josh Louwagie is product innovation director for Verisk’s ISO business, where he leads the development of digital forensic claims solutions and expansion of ISO’s digital-media database for the company’s insurance fraud system. He also helps develop innovative solutions for auto physical damage claims. Before Verisk, Josh spent 15 years at USAA in a variety of claims roles, overseeing glass and towing programs. He earned a BBA from Southern Minnesota State University and holds CPCU, AIC, SCLA, AINS, and AIS designations.

Matthew Frei

Matt Frei is Director of Data Science at Verisk and leads a team focused on applying AI to streamline claims handling with a particular focus on Computer Vision technology. His background is in claims fraud detection and automation, and he has a strong interest in the latest technologies. Matt is a graduate of North Carolina State University’s Institute for Advanced Analytics. Before entering the insurance world, Matt applied his analytical skills to nonpartisan political research, including working at the Pew Research Center in Washington DC. While there, he conducted and published a highly visible, data-centered analysis of national attitudes and trends.


Ethics and Decision-Making for the Investigator


Bob Horst, Esq.

Intended to venture beyond academic moral dilemmas, this interactive session will compare/contrast the massive differences between moral and ethical decision-making.  Using real world scenarios, the heuristic presentation discusses decision-making in the workplace and in our personal lives, with a focus on the insurance investigator.  Empirical, objective, sociological evidence – combined with ethical dilemmas -- will generate significant discussion, learning, plus critical self-examination.  Please bring your smartphone to maximize your understanding and participation.

Bob Horst

 484-243-6873

 rhorst@hkr.law

Bob is HKR’s Managing Partner. The 2021 founding of HKR marks his 30th year handling insurance coverage matters & litigation, with numerous jury trials to verdict. A native Philadelphian, Bob and his team litigate there frequently, along with the 5-county metropolitan area, though Bob and his team are frequently called on to represent insurers across the country. In addition to decades-long relationships with a number of insurer-clients, Bob has particular pride in his team’s role within several COVID-19 defense teams, task forces, and as coordinating counsel. First party property insurance remains his niche.

A frequent lecturer & author, Bob’s contributions to clients, colleagues and the industry include technical advice, trial tactics and efforts at thought leadership. He also co-authored and edited the treatise Extracontractual Litigation Against Insurers. Bob’s service to the industry includes over 6 years as General Counsel to the International Association of Special Investigative Units and its 4,000 worldwide members, along with a term on the National Committee of the Claims and Litigation Management Alliance (“CLM”).

Bob has been named among America’s Top 100 Civil Defense Litigators® since 2018. At various times he’s also been recognized as a Best Lawyer® and Super Lawyer®. Rated 10/10 by the national website avvo.com, Bob’s been profiled in a 2011 cover article of Claims Advisor magazine, “Ready to Rumble,” and has been quoted in The New York Times, The Legal Intelligencer, PropertyCasualty360, Law360, National Underwriter magazine, Student Lawyer magazine, The Jackson Clarion Ledger (Mississippi), and www.lawcrossing.com.

Aside from his practice, Bob truly enjoys coaching soccer. Currently an Assistant Coach at Central Bucks West High School in Doylestown PA – Go Bucks! – over the last decade, Bob’s been able to coach all 3 of his own children, along with a few hundred other fantastic young men and women as well. Happily married for 30 years, Bob’s wife, Kelly, is thrilled when he’s out of the house coaching.

FIRE AND WATER- A coordinated approach to investigate and litigate large losses through the use of engineers and attorneys.  How to save your company $millions.

This class will study large fire and water losses. It will discuss Homeowners issues in the investigation and litigation of fire and water losses.

The seminar will include an engineer and an attorney who actually work on these types of losses.

The losses will be discussed in an effort to show the attendees how significant savings can be achieved with a coordinated effort .

Questions during the seminar will be encouraged to develop a discussion like classroom atmosphere.


Lee Befeler, Esq.

Lisa Rivlin

JAMES F. SULLIVAN*

GORDON S. GRABER* Ñ à

LEE SCOTT BEFELER Ñ

DANYELLE  H. GOLLAND

* Certified by the Supreme Court

    of NJ as a Civil Trial Attorney

Ñ Rule 1:40 Qualified Mediator

à Also admitted in NY

SULLIVAN AND GRABER

ATTORNEYS AT LAW

60 MAPLE AVENUE

P.O. BOX  912

MORRISTOWN, N.J. 07963-0912

TELEPHONE (973) 540-0877

FAX (973) 540-8019

www.sullivangraberlaw.com

NEW YORK OFFICE

5 Columbus Circle, 11th Floor
New York, NY 10019

(212) 835-9462 

LEE BEFELER

Lee Befeler is a principal in the Morristown law firm of Sullivan and Graber, which has provided successful representation to insurance carriers and their insureds for over 35 years. In his 31 years at Sullivan and Graber, Mr. Befeler has lectured numerous times on insurance issues at the New Jersey Special Investigators Association and the New Jersey Vehicle Theft Investigators annual seminars and has prepared seminars for insurance carriers to satisfy CLE requirements. Lee Befeler is a certified R.1:40 Mediator for the New Jersey Superior Court.

Sullivan and Graber has extensive experience litigating insurance claims in Federal and State Courts in New Jersey and New York. The firm’s coverage work includes assisting insurance carries in claim investigations and the taking of examinations under oath. Sullivan and Graber also provides carriers with legal opinions on issues including, but not limited to, coverage and policy conditions such as duty to defend, bad faith claims, subrogation and indemnification.

The firm’s insurance work includes:

  • Arbitration and mediation
  • Auto Theft
  • Arson
  • Bad faith claims and litigation
  • Business and commercial coverage
  • Dram shop litigation
  • Environmental claims, coverage and pollution exclusions
  • Examinations Under Oath
  • First Party and Third Party coverage
  • General liability
  • Homeowner’s insurance
  • No Fault/PIP
  • Personal injury and wrongful death litigation
  • Product and Premises liability
  • Professional liability
  • Subrogation
  • Uninsured and Underinsured Motorist coverage

In addition to general casualty work, Sullivan and Graber is recognized as a leader in the specialty practice of insurance fraud. The firm uses innovative techniques, advanced technology and hard work to fight fraud against insurance carriers. Sullivan and Graber pioneered the use of declaratory judgment actions to combat large fraud schemes resulting in significant savings to the insurance industry. The firm adopted the procedural tools developed in those actions to curtail fraud in POP, personal injury and property damage cases. Sullivan and Graber’s early use of injunctive relief to stay PIP suits and arbitrations pending the resolution of fraud and restitution actions in the Superior Court greatly reduced insurance carrier’s litigation costs as well as obtaining recoveries in the tens of millions of dollars for multiple insurance carriers.

Lee Befeler received his J.D. from the McGeorge School of Law, Sacramento, California in 1987. Mr. Befeler is admitted in New Jersey.   

 

Lisa Rivlin


Vice President of Marketing

HEADQUARTERS                                                                    

Forensic Accounting

256 Columbia Tpke, Suite 206

Florham Park, NJ 07932

800-849-9119

info@FCNAPartners.com

Moneyball:  The Art of Winning the Worker's Compensation Game


This presentation will focus on identifying accessible proof fraud, evaluating the likelihood of success pre-litigation, corralling compelling evidence, and ensuring you’ve identified a solvent target to maximize the likelihood of recovery in worker’s compensation premium fraud investigations.

Ashley R. Lynam is a partner in Montgomery McCracken’s Litigation Department and head of the firm’s Special Investigations Unit. A former Philadelphia rape prosecutor, Ashley combines her law enforcement background with increasing use of technology, data, and analytics to identify fraudulent conduct, organized networks and combat questionable claims. Ashley conducts first-party investigations including examinations under oath and coverage opinions for claims involving PIP, fire and casualty losses, premises liability, worker’s compensation claim and premium fraud, multi-jurisdictional rate evasion, suspected arsons, thefts, and personal articles policy claims. She also investigates suspected medical provider fraud, attorney solicitation, and unreasonable and abusive billing procedures in third-party investigations and litigation. Ashley works closely with both local and national fraud-fighting agencies, including the National Insurance Crime Bureau (NICB), International Association of Special Investigation Units (IASIU), and local and federal law enforcement authorities to offer collaborative and comprehensive services to her clients.

Ashley graduated summa cum laude from Villanova University where she was the president of their nationally-ranked mock trial team. She graduated cum laude from Villanova University School of Law where she was the chair of the Moot Court Board. Ashley lives in Berwyn with her husband, Shane, their two daughters, Lilly and Violet, and their beloved dog, Dominic.

Jacob A. Sand is an associate in Montgomery McCracken’s Litigation Department. He has represented clients in federal and state courts across the country as lead and national counsel. Jacob’s practice focuses on complex high-stakes disputes and he has handled a wide variety of matters in that regarding including those arising out of claim and company-based fraud, theft of intellectual property, allegations of institutional negligence, false and deceptive practices claims, hacking and cybersecurity incidents, and contract disputes.

Jacob also conducts internal investigations for insurance carriers, private companies and government agencies. Jacob takes a hands-on approach to investigating and is personally involved in all facets of the investigatory process from interviewing witnesses to gathering digital and forensic evidence. Jacob’s experience allows him to help clients respond to crises by identifying potential risks and developing solutions.

Prior to joining Montgomery McCracken, Jacob was a Counsel at a regional law firm and an Assistant District Attorney in Philadelphia. Jacob is a graduate of Johns Hopkins University and the University of Pennsylvania School of Law.

Interviewing and Statement Techniques

                                                                                                             Frank X. Sztuk

                                                                                                                                                            John Sargent

Insurance adjusters, investigators, agents and any other insurance personnel who have the opportunity to interact with the public are the first line of defense against insurance fraud.  Interviews and statements offer the best opportunity to obtain information to identify the elements of claims and work toward identifying those cases that may be potential fraud. 

The goal of this program is to provide a level of awareness and expertise in the taking of statements as they pertain to insurance claims.  The intended purpose is to focus on the methodology involved in how to properly initiate and conduct the interview and to elicit information that will lead to the reasonable resolution of a claim.

Upon completion of this course the attendees will have the ability to understand who is committing fraud and why, selecting those cases that need comprehensive interview statements and the proper way to complete that investigative task.

FRANCIS X. (FRANK) SZTUK

Frank is the Senior Vice President/Investigative Services for the Delta Group.  He came to Delta after a rewarding 36-year career with the Hanover Insurance Company, where he developed the Special Investigation Unit Program at that company.  He retired as the National SIU Strategist, responsible for oversight of one of the leading anti-fraud programs in the industry.  He served on many boards and councils in his career, most notable being the immediate past-Chair of the Massachusetts Insurance Fraud Bureau.  He is also a former Chair of the national Coalition Against Insurance Fraud as well as the NY Alliance Against Insurance Fraud, where he still chairs the Public Outreach Committee of that organization.  He sat on the NJ Insurance Commissioner’s Fraud Advisory Board and the NJ Insurance Council Anti-Fraud Committee.  He has lectured both nationally and internationally on the subject of insurance fraud and continues to present at various programs such as the ISO/NICB Insurance Fraud Management Conference and the IASIU annual fraud conference.  Frank is a lifelong resident of New Jersey, where he lives with his wife, Angela.

JOHN SARGENT

John Sargent is a Senior Vice President at the Delta Group.  Sargent joined the Delta Group in November 2020. Before joining the Delta Group, he spent 25 years at MetLife where he led the SIU program for the last 16 years. He began his professional career as a police officer in Massachusetts.

While with MetLife he also served in several positions at the Coalition Against Insurance Fraud to include Treasurer and most recently the Co-Chair from which he stepped down in October of 2020; He was the Vice Chair of the Board of Governors for the Insurance Fraud Bureau of Massachusetts and the past Chairman of the New York Alliance Against Insurance Fraud, he was also an advisor to the CEO of the National Insurance Crime Bureau.

Sargent has spoken extensively on the topic of Insurance Fraud and the management of special investigation units throughout the United States, Australia, and Germany.

Investigative Hindsight and the Everest Like Climb to 20/20

AN INSIDE LOOK AT THE DAY-TO-DAY COMPLEXITIES OF SURVEILLANCE & INVESTIGATIONS



This 60-minute presentation will take us on an exploration into the challenges facing surveillance and investigative companies in today’s turbulent climate and how technology and innovation are forging a clearer path forward.  Throughout this workshop, we will be showcasing the intricacies of proper background research, harnessing the power of modern technology, and using collaborative expertise to put a stop to the mountain of fraud in the United States.  As hindsight is always 20/20, we will be addressing techniques to get in front of the curve to help perfect investigations before they start.  Key takeaways from the class will be Tips and Tricks for successful investigations, how to create logical workflows during surveillance and more.  Join us on our forward-thinking path to stopping fraud.

www.aiccompanies.com

Po Box 831, Medford New Jersey 08055

T: 1-800-988-0317| F: 609-521-4472| E: ReachUs@aiccompanies.com

                      

                      

Matthew Anderson

President

Matthew Anderson is the President and Founder of AIC Companies, LLC. He established the investigative firm in 2014 with a radical approach to Surveillance and Investigative Services in the claim’s industry.

Graduating from Rutgers University, The State University of New Jersey, Matthew centralized his focus on Criminal Justice and Investigative Practices. He kickstarted his career as a Field Investigator in the investigative industry with a regional firm in 2005 investigating potentially fraudulent workers’ compensation claims. Through almost a decade, Mr. Anderson honed his skills from the field investigator role to becoming the Lead SIU Administrator and finally the Director of Operations.

As President of AIC Companies, LLC, Matthew is now responsible for running all facets of the firm. Matthew’s passion has been to introduce groundbreaking solutions to the investigative industry that has been languishing for years with limited innovation and stagnation. At the helm of AIC Companies, LLC, Mr. Anderson has put together an All-Star Team of investigators leading the outfit into the future.

                                

Chad Hinds

Investigative Director

Chad Hinds is currently the Investigative Director for AIC Companies, LLC. With a wealth of knowledge and over almost a decade and a half of experience, Mr. Hinds has been able to pursue revolutionary investigative philosophies at AIC that are helping to change the DNA of the investigative landscape.

Mr. Hinds started his investigative career in 2007 as a Field Investigator for a regional surveillance firm based out of New Jersey. Through the years, Mr. Hinds quickly ascended the ranks of the agency through remarkable investigative skills unseen in the industry. With his stellar expertise, Chad took the helm of the SIU Department where he became one of the best data miners in the Northeast.

In 2014, Mr. Hinds joined AIC Companies, LLC as the Investigative Director overseeing all the field operations at the firm. Here, Chad was able to expand on his knowledge of SIU and Surveillance to push AIC Companies into an innovative territory no other investigative company has ever seen. 

Identity Fraud-Synthetic & Stolen Identities

As long as there are financial opportunities to exploit, fraudsters will continue to look for ways to generate their next payday.  This latest scheme was first noticed in the banking industry, where fraudsters perpetrate losses totaling tens of billions of dollars.  This was just the proving ground where these swindlers perfected the scheme before bringing that pain to the insurance industry.  More and more carriers are now starting to see fake identities showing up in their files.  Building complex tools that can unwind Synthetic Identities and stop them before they make off with hard-earned premium dollars is a challenging prospect, but it’s possible.  Join this session to learn how the scheme works and how you can pull back the curtain on this fraud scheme to separate truth from fiction.

Louis Riggio                                                                          

Michelle Miller

Louis Riggio

Louis Riggio brings over 25 years of experience in the P&C Insurance and Training industries to his role as Training & Communications Manager for ISO ClaimSearch Solutions. Louis has held numerous positions within these industries over the course of his career with his longest tenure in Claims. He also leverages a diverse background in Operations, Product Development/Support and Project Management. These skills allow Louis to support and enhance the ISO ClaimSearch Solution customer experience.

Michelle Miller

Michelle spent over 21 years in the insurance industry and worked "from the ground up" through almost every department in claims.

In her former position as a Senior Intelligence Analyst, she had several responsibilities;

  • Conducted cursory investigation of suspected fraudulent claims
  • Analyzed claims for fraudulent trends using the program “Netmap”, while focusing on fraud initiatives within the company
  • Prepared detailed reports of findings with executive summaries and presented to upper management
  • Scanned internet for potential fraud cases
  • Completed special projects for fraud claims Director
  • Liaisoned to other SIU units regarding pending fraud initiatives
  • Tasked with training new analysts and developed new protocols for the Business Intelligence Unit
  • Conducted interviews of subjects of investigation

In 2013 & 2016 Michelle was Plymouth Rock President’s Award Recipient. Additionally, she received 2013, 2014, 2015 & 2016 Plymouth Rock Fraud Recognition Awards for outstanding fraud detection and investigation on multiple major case initiatives that led to substantial financial impact to the company’s bottom line. Several of these cases resulted in arrests and convictions of medical providers.

In 2019, she started her new journey with Verisk Analytics.

PIP Legal Update

                                                                                                                              

Ken Pringle, Esq.                                                                  

Pringle, Quinn, Anzano, P.C.

Belmar Office:

701 Seventh Avenue

Belmar, NJ  07719

Telephone:  732-280-2400

Kenneth E. Pringle was admitted to the New Jersey and District of Columbia bars in 1983.  He graduated summa cum laude from Mount Saint Mary’s College and cum laude from Georgetown University Law Center, where he was a member of the editorial board of the Georgetown Law Journal.  He served as law clerk to the Honorable Clement F. Haynsworth, Jr., Senior Circuit Judge of the United States Court of Appeals for the Fourth Circuit.  He has been associated with the Washington, D.C. law firms of Hogan & Hartson and Ross, Dixon & Masback. 

Mr. Pringle has extensive experience in a broad range of insurance defense and coverage areas on behalf of numerous U.S. insurance companies, including the CNA Insurance Companies, Harbor Insurance Company, Chubb Insurance Company, the Allstate Insurance Company, the Prudential Property and Casualty Insurance Company, Liberty Mutual Insurance Company, Selective Insurance Company and AMICA Mutual Insurance Company.  Mr. Pringle represents the Special Investigation Units of Allstate, Prudential, Liberty Mutual, CNA, Colonial Penn Insurance Company, Bayside Insurance Company, Selective Insurance Company, AAA/Midlantic (Keystone) and USAA Casualty and Insurance Company, and has represented a number of non-marine syndicates at Lloyd’s, London in connection with insurance fraud matters ranging from fraudulent property and personal injury losses to staged deaths and accidents, to healthcare fraud.  Mr. Pringle has brought suit on behalf of his clients in New Jersey against numerous healthcare providers alleging violations of the NJ Insurance Fraud Prevention Act and the Racketeer- Influenced and Corrupt Organizations Act.  In addition, he has litigated in the state and federal courts in numerous liability areas, including employment law, comprehensive general liability, automobile liability, directors’ and officers’ liability, public officials’ liability and board of education liability.  Mr. Pringle serves as general counsel to the New Jersey Special Investigators Association, Inc.

Mr. Pringle is a past member of the Board of Trustees of Mount Saint Mary’s College, Emmitsburg, MD, and is a member of the Summit Bank Advisory Council, and has served as Mayor of the Borough of Belmar since 1990.  He is married to Kathleen Ellis; they reside in Belmar with their two children, Emily and K.J.

Social Media Discussion with the @OSINTMillennial

   Melissa Sweeney                                                                                                                                             

Come discover new ways of mining social media profiles in this ever changing cyber world using strategic OSINT techniques.  In this session, we will discuss methods of finding information on a variety of platforms such as Facebook, Instagram, TikTok, and Venmo.  Social media and other OSINT findings have proven to be incredibly helpful in rooting out fraud, or leveraging reductions in settlement.  It’s important to be up to date on the latest tricks and trends.

 Crum & Forster

Melissa Sweeney

Melissa Sweeney is an Investigative Analyst for Crum & Forster, a leading national property, casualty and accident & health insurer with a large, diversified specialty platform. Melissa specializes in social media, open source intelligence (OSINT) and background investigations. She is currently pursuing her second Master’s Degree in Digital Media Design after recently completing her Master’s Degree in Criminal Justice. Melissa is an active NJSIA board member. In her free time, she is an avid ball hockey player and assists in managing social media for the United Women's Ball Hockey Foundation.

Telehealth, COVID and Fraud Opportunities


Kennedy Vuernick, LLC

The Meadows Office Complex

301 Route 17 North, Suite 800

Rutherford, NJ 07070

E-Mail: jkennedy@kvlawllc.com

Website: http://www.kvlawllc.com 

Tel: (201) 636-9980

Direct: (201) 636-9988

Fax: (201) 636-9990

John Kennedy, Esq.

           

This presentation will summarize the NJ law on telehealth; the various state and federal COVID waivers of restrictions on telehealth (some of which have expired; some of which are still in effect); and discuss the fraud vulnerabilities these waivers created. 

John Kennedy, Esq.

John Kennedy is an attorney with considerable expertise in combating insurance fraud, having spent over 10 years heading the Office of the Insurance Fraud Prosecutor’s civil and criminal enforcement efforts.  Mr. Kennedy is now in private practice where he uses his knowledge and expertise to help insurance companies recoup money lost to insurance fraud.

Before leaving OIFP, Mr. Kennedy was second-in-command of an office with a staff of 120, and a case list averaging several hundred active criminal and civil cases.  Simultaneously, Mr. Kennedy was lead prosecutor in some of the office’s most significant prosecutions, securing state prison sentences for, among others, doctors who accepted cash kickbacks for patient referrals, and an insurance producer who stole nearly $2 million from his clients.

Mr. Kennedy has prosecuted a wide range of white-collar crimes, including insurance frauds of all kinds, environmental crimes and tax frauds.  Mr. Kennedy is also an accomplished appellate advocate, having argued three cases before the New Jersey Supreme Court and dozens before the Appellate Division.

Mr. Kennedy received his J.D. from New York University School of Law, and his bachelor’s degree from Saint Peter’s College.          


Things That Make You Go Hmmmm: A Closer Look at Trending Off-Schedule Medical Procedures in NJ PIP and their Impact on Claims Handling and Investigations

Jonathan C. Magpantay, Esq.


As the current NJ PIP Fee Schedule continues to age, and new CPT codes and practice trends emerge, the use of off-schedule medical procedures remains prevalent.

This presentation will discuss several off-schedule medical procedures seen in NJ PIP litigation: biofeedback and psychotherapy, neurosurgical monitoring, urine drug testing (UDT), and medications and devices billed by medical providers. What are these procedures, how the procedures are billed to maximize recovery, and what to look for in claims handling and investigations.

Jonathan C. Magpantay

15000 Midlantic Drive, Suite 200

P.O. Box 5429

Mount Laurel, NJ 08054

(856) 414-6401

jcmagpantay@mdwcg.com

Jonathan is a member of the firm's Fraud and Special Investigation Unit (SIU) group where his practice is dedicated to large loss and medical provider fraud. He handles matters that focus heavily on fraud investigation, and involves the assessment and evaluation of both medical provider fraud and fraudulent claims on the part of clients' insureds. Jonathan is experienced in dealing with insurance coverage disputes, representing insurance carriers across multiple states for the purposes of SIU investigation, bad faith litigation and general defense litigation. He has broad and extensive experience in New Jersey Personal Injury Protection (PIP) litigation and appears regularly before the courts and administrative bodies. Most recently, Jonathan led a national initiative for the modernization and administration of automobile first-party medical claims for one of his clients.

Before joining Marshall Dennehey, Jonathan was an attorney for the largest insurance carrier in the United States where he handled PIP disputes, insurance coverage matters, and automobile and fire claim litigation. Jonathan led national staff counsel review teams focusing on ethics, best practices, operations, and continuous improvement. He was also a project member on a global quality improvement initiative tasked with improving legal services throughout the insurance carrier’s national staff counsel operation.

Jonathan earned his Chartered Property and Casualty Underwriter (CPCU), Associate in Insurance Services (AIS), and Associate in Personal Insurance (AIP) designations from the American Institute of Chartered Property and Casualty Underwriters (The Institutes). He is currently a member of the New Jersey Superior Court, Camden Vicinage, Diversity, Inclusion & Community Engagement Committee.

After graduating from law school, Jonathan clerked for the Hon. Ronald J. Freeman, J.S.C. (ret.) in the civil division of the New Jersey Superior Court, Camden Vicinage.

Rescission The Right Way: Identification, Investigation, and Litigation

This session will focus on rescinding policies based upon material misrepresentations during the underwriting process.   We will focus on all lines of insurance since rescission is a remedy for all types of policies where there has been a material misrepresentation.   Identification of a material misrepresentation is perhaps the most important step, and we will concentrate on identifying underwriting fraud both pre-loss and post-loss.  The investigation stages will set forth the key elements to confirming the material misrepresentation, and how you will handle different types of claimants, including whether it is a first party or third party claim.  Finally, we will analyze the most efficient ways to successfully litigate these claims when rescission is challenged or the case has significant value or issues that warrants being proactive.


Matthew Werbel, Esq.

Stephen Katzman, Esq.

Methfessel & Werbel, P.C.

3 Ethel Road, Suite 300

Edison, New Jersey 08818

Ph. 732-248-4200 ext. 150

Stephen Katzman

Loyola University School of Law, J.D. 1981
Boston University, B.A. cum laude, 1978

Stephen began his career as an Assistant District Attorney in New Orleans, Louisiana, eventually becoming the Division Chief supervising approximately 30 attorneys. He also served as the homicide and sex crimes trial prosecutor.

In 1985 he was admitted to the bar in New Jersey and the U.S District Court for the District of New Jersey. Upon moving to New Jersey he joined Methfessel & Werbel, where he served as an insurance defense trial attorney specializing in fraud, defamation defense, property damage, subrogation, coverage and negligence actions. In 1989 he was admitted to practice before the U.S. Court of Appeals for the Third Circuit.

Stephen left M&W in 1989 to form the law firm of Maloney and Katzman, which then became the Law Office of Stephen R. Katzman, where he handled over 1500 property damage, fraud, fire, coverage, defamation defense, subrogation, products liability and bodily injury files over a period of 13 years. He rejoined M&W in 2002 as a member of the first-party/property team.  He and his team specialize in insurance fraud, defamation defense and insurance coverage matters.

Matthew Werbel

Tulane University School of Law, J.D. 1998
Franklin & Marshall College, B.A. 1994

Mr. Werbel joined the firm following a successful clerkship with the Honorable Edward W. Beglin, Jr., Assignment Judge of the Superior Court in Union County. At Tulane he specialized in environmental litigation and regulatory actions, receiving a certification in Environmental Law as well as a J.D.

Mr. Werbel presently represents insurance carriers, insureds, and self-insureds in the investigation and defense of both first and third-party claims.

Mr. Werbel handles cases in many areas, including environmental, fraud, first and third party coverage, inland marine, liability, and subrogation. Additionally, Mr. Werbel has successfully argued several cases before the Appellate Division including several that were approved for publication. Mr. Werbel also handles substantial subrogation claims including the early investigation of those claims.

Mr. Werbel has also presented many seminars on topics such as Mold, Bad Faith, Insurance Fraud, Unfair Claims & Settlement Practices Act, Staged First Party Claims, Additional Insured and Indemnification Claims, Collapse Claims, and Duty to Defend Negligent and Intentional Torts.


Auto Theft Trends- Why we are failing and what can be done to correct the problem     


Cory Rodriguez

This workshop will discuss stats, trends, and where we are failing in respects to auto theft prevention (victims, law enforcement, the court system, insurance companies), and what needs to be done to correct the explosion of car thefts. 

 

Cory Rodriguez

Detective Sergeant Cory Rodriguez, is assigned to the New Jersey State Police, Motor Vehicle Crimes North Unit, Auto Theft Task Force.  He has been a member of the New Jersey State Police for over 14 years. DSG Rodriguez has attended the New York City Police Department’s Auto Crimes School, Interpol's Project Formatrain, is an IAATI Certified Vehicle Crime Specialist, a certified Berla vehicle forensics investigator, and a Certified Fraud Examiner.  DSG Rodriguez is also 2nd Vice President of the Northeast Chapter of the International Association of Auto Theft Investigators. 

Vehicle Theft vs. Fraud

                                                          

Michelle L. Price

Vehicle Theft vs. Fraud is a one-hour presentation designed to assist participants in determining if vehicle damage claimed after recovery is consistent with a theft scenario.  This course covers vehicle theft methods consistent with various vehicle types. It also examines how manufacturer’s ignition systems and technologies are possibly defeated to allow vehicles to drive away.  Ultimately, this course provides participants with information needed to understand elements and conditions consistent with actual thefts vs. fraudulent claims.

 Michelle L. Price

Consultant / ACTAR / Baltimore

mprice@rimkus.com

Ms. Price holds an A.A. degree in Criminal Justice and is an Accredited Accident Reconstructionist through the Accreditation Commission for Traffic Accident Reconstruction (ACTAR #2963). Starting as a patrol officer in 1995, Ms. Price was a member of the Baltimore City Police Dept. for 25 years including 8 years as a K-9 Handler.

From 2008 until her retirement in August of 2020, she worked on the Baltimore City Police Dept. Crash Team as a detective where she investigated hundreds of serious and fatal vehicle collisions and has 12 years of experience in traffic crash reconstruction involving motor vehicles, commercial vehicles, motorcycles, and pedestrians.

Ms. Price’s areas of expertise include motor vehicle crash reconstruction, motorcycle crash reconstruction, pedestrian/bicycle versus vehicle crash reconstruction, commercial vehicle crash reconstruction, event data recorder (EDR) analysis for passenger vehicles and heavy trucks, seatbelt analysis, and rollover crash reconstruction. She has extensive training in crash scene mapping using a Total Station and hand measurements. Ms. Price is an avid motorcycle rider, which gives her unique knowledge in the investigation of motorcycle collisions and operator actions/reactions.

Ms. Price was an adjunct instructor for the Maryland Crash Reconstruction Committee, where she taught courses in the area of crash reconstruction including Event Data Recorder Use in Traffic Crash Reconstruction and Investigation of Motorcycle Crashes. She was an adjunct instructor with the Maryland State Highway Administration, Office of CHART (Coordinated Highways Action Response Team). Ms. Price was an instructor with the Baltimore City Police Academy, where she taught courses in procedures for handling a collision scene/investigation, the automated crash reporting system, and traffic incident management.





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