WESTWOOD, Mass. (November 28, 2006) – MIB Solutions, Inc. presented a seminar on its Claims Activity Index (CAI), the first industry-wide database to help prevent life insurance claims fraud, to the delegates of the 97th annual meeting of the International Claim Association in Seattle last month. Featured speakers, Douglas M. Mertz, MIB Solutions� vice president of sales, Blake Cole, Mutual of Omaha�s manager of special investigations and Attorney Stephen H. Galton, senior partner of the Los Angeles law firm Galton & Helm LLP, emphasized the potential impact of CAI on the industry�s fraud fighting efforts by retrospectively examining multiple case studies (including the well publicized �California Grannies� case) to illustrate that had CAI been in place at that time, the payment of tens of millions of dollars of fraudulent life insurance benefits could have been potentially avoided.
The CAI is a shared, industry-wide data exchange under which subscribing life insurance companies are notified that they share claims on the same insured�s through a secure Internet connection; investigators glean critical information from the data payload and then can speak directly with their peers to compare facts, identify inconsistencies, rapidly gather evidence and then make their claim decisions independently. Nearly 30 leading U.S. and Canadian life insurance companies have joined forces in this alliance with more committing each week.
A Grannies Tale
In May 2006, Helen Golay and her accomplice Olga Rudderschmidtt, both women in their 70s, were arrested in Los Angeles for insurance fraud after they befriended two unemployed homeless men, took out multiple life insurance policies, waited until the contestable period had expired (two years), and allegedly had them murdered in separate hit-and-run accidents. Discovery of the fraud was reported by the media as a chance meeting between two detectives, one who investigated the first unsolved death in 1999 (significant life insurance benefits were paid to Golay and Rudderschmidtt at that time) and one who investigated the June 2005 death of the second man (McDavid). His demise spurred a series of 11 life insurance claims on policies from nine different companies totaling more than $3.6 million dollars.
In his presentation, Attorney Galton, who recently won a summary judgment for a mid-sized southwestern life insurer that halted a $100,000 benefit payment on McDavid�s life to Golay stated, �Over $2.1 million dollars were paid by four companies before detectives uncovered this scam and alerted the other carriers.� �The sheer number of policies on McDavid would have instantly raised suspicions had CAI been in place and when investigators conferred, incriminating information like listing multiple occupations on insurance applications including investor, writer and producer when he was unemployed, or the fact that Golay�s beneficiary relationship to the insured was sometimes listed as fianc� and sometimes cousin, would have raised immediate red flags prior to any payment of benefits,� emphasized Galton, a 35 year industry veteran. �The �grannies� scam is a case-in-point for how an industry-wide resource like this can expedite claim investigations. Fraud is perpetrated in a multitude of ways� A facility to share information is one of the industry�s best defenses.�
A Commitment to Unite the Industry
Blake Cole, a 25 year claim investigator for Mutual of Omaha, one of the early adopters of CAI, spoke to the delegates about his company�s commitment to unite the industry against claims fraud. �Our investigations are rigorous, exhaustive and expensive. We use every means to discover fraud and encourage law enforcement to prosecute it vigorously wherever possible. Claims fraud costs our industry hundreds of millions of dollars each year. We welcome a new tool that has the potential to alert us to fraud on contestable and incontestable claims and boosts our efficiency in gathering evidence,� Cole said. �Our company saw the potential, recognized the short-term commitment to get this industry-wide database off the ground and now anticipates realizing significant long term benefits.�
About MIB Solutions, Inc.
MIB Solutions markets products that help insurance companies make better underwriting and risk management decisions. Its offerings include products that reduce applicant and claims fraud, products that enhance underwriting productivity and enterprise risk management and actuarial analytics that provide an industry-wide perspective for compliance and business decisions. MIB Solutions, Inc. is a division of MIB Group, Inc. which is the premier provider of fraud databases used to detect and deter applicant fraud for life, health, disability income and long-term care insurance and is a leading facilitator of electronic insurance commerce. For more information visit www.mib.com.
About Mutual of Omaha
Mutual of Omaha is a full-service, multi-line provider of insurance and financial services products for individuals, businesses and groups throughout the United States. Founded in 1909, Mutual of Omaha and its affiliate companies manage assets in excess of $18 billion and are ranked among the Fortune 500.
About Galton & Helm
The Los Angeles law firm of Galton & Helm LLP was formed in 1985 and has developed a national reputation in specific areas of insurance law. The firm is committed to providing the highest quality of legal services within its specialized areas of practice, at rates which are equitable and fair. While the firm is equipped with state of the art technology, all of the attorneys in the firm consider personal service to be an important objective.
