Conference Program/Sessions

Would you like to know more about underwriting microdosing or psychedelic therapy risks? Would you like to get a better understanding of other risk assessments? Do you have any other burning questions for an underwriter? If so, then this session is for you. Please join us for a dynamic and engaging discussion with Anastasia Jaegerman, VP Underwriting and Chief Underwriter at Optimum Life Reinsurance. You won't want to miss it.

The claimant does not accept your decision to deny benefits and has now sued the company. As you prepare to meet with your attorney terms like burden of proof, summary judgment, attorney-client privilege and others that you have heard come to mind. You are not sure exactly what they mean, and more importantly, how they might impact you. No worries. Get a practical understanding of insurance litigation basics from start to finish by two attorneys who have seen it all. Bring all of your questions and they will be answered, even if the answer if the answer is “That depends.”

o The Family Medical Leave Act (FMLA) of 1993 is still misunderstood by many employers. The Americans with Disabilities Act (ADA or ADAAA) passed in 1990 was the world’s first comprehensive civil rights law for people with disabilities. The basics of the FMLA & ADA proved more complicated than anticipated, and employers report that it is now more difficult than in previous years to approve leaves and coordinate leave types. Join us for a deep dive into the FMLA & ADA as we review both laws and how these intersect with disability claims.

Evidence suggests that the healthcare industry has faced significant employment challenges, particularly exacerbated by the pandemic. These staffing issues extend to insurance operations, which grapples with knowledge loss due to retirements, attrition, and intercompany movement. Additionally, the impact of AI on the future of work remains uncertain and will come with its own set of opportunities and challenges.

In this panel discussion, our experts will share innovative approaches to address staffing challenges. From attracting and hiring skilled employees to retaining them through effective engagement strategies, we’ll explore ways to create a motivated and satisfied (and happy!) claims workforce. Join us as we uncover the smartest solutions for ensuring the best possible outcomes for both employees and the industry

This session aims to assist the claims specialist manage disability claims related to mental health or having a behavioral health component. The session will cover recent court decisions interpreting the enforcement of limitations on the benefits period for such claims, discuss what information is useful when dealing with claimants with behavioral health impairments, and offer guidelines for conducting thorough and empathetic investigations into mental health-related disabilities. We hope to have an interactive session with attendees. Sharing your experiences and effective communication strategies when managing such claims is encouraged. CLE credit is being sought for this program.

Join us for an insightful discussion exploring the emerging threat of identity risk in Living Benefit claims. From fictitious caregivers in LTC to fabricated and stolen identities in Chronic Illness, the growing threat from identity risk is a growing trend not to be ignored. This fascinating discussion will delve into the complexities of identity risk in Living Benefits, discussing the risks, current trends, and best practices for mitigating these potential losses. Join us for an engaging session to learn how to identify, investigate and deter this type of activity in your business.

Join us for a collaborative roundtable discussion where everyone from novices to experts, innovators, and stakeholders convene to discuss, analyze, and strategize around adopting emerging technologies, understanding current trends, and facing legacy challenges in Claims and Underwriting Management. This session offers an opportunity to ask questions both prior to and during the session to maximize our learning potential. Come prepared for a lively conversation with industry peers as we explore the art of the possible!

This is not your usual deposition preparation presentation. Our panel, who have expertise as deponents and counsel, will cover scenarios that are common but not always discussed, like how to handle questions that you aren’t sure you want to answer, what to do when you get noticed to appear tomorrow, how much prep really is enough, what do you mean I might have to dress up (or dress down) and do I still have to answer when my counsel instructs me not to? If you’re interested in learning how to advocate for yourself and communicate with your counsel all while still successfully representing the company, we invite you to join us.

With ever-increasing Nomadic and Traveler fraud impacting insurance companies’ bottom lines, a panel discussion weighs in on schemes and real-life examples on what was done to combat and document the fraud. We hear genuine examples from district attorneys’ perspectives as well as from a former FBI agent. In a session moderated by the Fraud and Risk Management Committee, we explore case studies from identification to indictment to put a finger on the current pulse and methodology behind this fraud.

Our crack team of experts will cover topics like agent licensing for the purpose of paying override commissions, non-compete issues, monitoring replacement activity, working with outside counsel to make sure independent agents are described properly in litigation, and much more. Join us as we sift through the gray areas of independent agents and learn together.

Mediation has become an increasingly important option to resolve disputes; however, not everyone understands what to expect. Join us for a discussion about whether to mediate your dispute, tips to have a successful mediation--including selecting a mediator, preparing for the mediation, what happens during mediation, and steps you can take towards a resolution both parties can live with.

Does the mere mention of a bad faith claim raise your blood pressure? When dealing with a bad faith claim and the risk of extra-contractual damages, the stakes may feel very high. Fear not. This session will cover the basics of what a bad faith claim consists of, some recent case developments, and practical strategies for both defending and preventing bad faith claims. We will discuss changes and strategies that can be implemented at every step of the process, from claims review to final disposition in the courts. Additionally, we will examine how an insurer can flip the script and prove that its conduct demonstrates good faith in its claims review by utilizing a humanizing approach.

Life insurance companies are transforming their claims processes by incorporating empathy-based tools and methods, shifting away from a purely transactional approach. This session will delve into the distinction between empathy and sympathy, exploring how insurers can utilize empathy to foster strong relationships to develop long lasting customers even after the claim has been settled. We will also discuss best practices for communicating with policyholders and beneficiaries, as well as crucial self-care practices for claims professionals to maintain their well-being while providing support during customers' most challenging times. This session will also explore how Empathy, an innovative technology company, offers personalized, compassionate support for bereaved families, setting a new standard for managing grief. Join us for an engaging and interactive experience!

Don't be caught in the Matrix! Join a panel discussion with experts in claims/technology that have had to navigate their way through vetting and implementing new technologies. They will share their experiences, do's and don'ts in a holistic manner in consideration of the impact on other departments.

Join us for the always-popular Advanced Life Claims Roundtable, an attendee-driven forum for discussion of life claim topics. The session moderators will solicit topics and questions from you and other attendees prior to the conference and design the conversation around these submissions, ensuring you will hear about interesting and pertinent subjects. This session is a fantastic way to ask questions of and hear from your peers within the industry.

Join us for the always-popular Advanced Life Claims Roundtable, an attendee-driven forum for discussion of life claim topics. The session moderators will solicit topics and questions from you and other attendees prior to the conference and design the conversation around these submissions, ensuring you will hear about interesting and pertinent subjects. This session is a fantastic way to ask questions of and hear from your peers within the industry.

Saddle up for this year’s Annuity Roundtable and join us for an invigorating discussion. This session will provide answers and an open forum on a variety of hot topics and issues affecting annuity claims. The speakers will solicit your questions ahead of the conference so that this session will be designed for you to get all your questions answered. We hope to see you there!!

How to maintain and improve engagement in claim operations through upskilling and technology adoption. Join this session to learn more about the skills needed to better leverage and apply meaningful technology solutions to improve claimant experience and operational efficiency.

Join us for a lively and enlightening panel discussion that delves into the unconventional yet vital role of funeral homes in the life claim process. This panel will explore how the seemingly morbid realm of death data can significantly impact the efficiency and accuracy of claims processing. We will ’ll shed light on the intricate relationship between funeral homes and funeral financing companies and how they play a pivotal role in facilitating funeral expenses by providing financial assistance to families during their time of need. We will ’ll delve into the mechanics of this process, examining what factors determine its usage and how funeral homes navigate these arrangements to ensure smooth claims processing. Our panelists will share their firsthand experiences, highlighting the challenges and successes encountered when collaborating with insurance providers. From streamlining paperwork to overcoming bureaucratic hurdles, we will ‘ll uncover the best practices for fostering seamless communication and cooperation between funeral homes and insurance companies. Ultimately, our aim is to illuminate how aligning interests and optimizing processes can alleviate stress for grieving families and enhance the overall claims experience.

This presentation explores the impact of Commissioner O'Malley on the Social Security Administration (SSA) since his confirmation. By focusing on key reforms and strategic shifts introduced under his leadership, the session highlights how these changes have altered the agency's operations. It delves into the specific measures implemented, such as modernization of processes, enhancements in technology, and policy changes. Additionally, the presentation assesses the effects of these reforms on overall productivity within the SSA.

If you're looking for a session that packs maximum punch in an efficient amount of time, sign up for this one. Implementing and administering an LOA program is intimidating and grueling. If you are struggling to keep up with market demands and stay on top of constant change you are in good company. We will discuss LOA nuances, trends, best practices, and how technology can help. You will learn the moves and hone the skills that you need to build a strong & healthy offering.

Please join our panel of highly respected defense attorneys from the East and West coasts for this Legal Year in Review presentation. The members of this presentation team will explore current trends in local and national litigation that impact the disability claim arena. This session is a must for all claim professionals that manage IDI, Association and LTD claims as well as in house and outside defense counsel.

In the bustling conference hall, insurance claims professionals and leaders gather eagerly for a session titled "It's Training's Fault... Or Is It?" A provocative title, indeed, reflecting the complex interplay between training initiatives and organizational challenges. As the session unfolds, attendees delve into the nuanced landscape of identifying genuine training needs amidst multifaceted workplace issues. They explore the evolving dynamics of how people learn in today's digital age, dissecting the efficacy of traditional methods against modern learning modalities. From immersive simulations to bite-sized microlearning, the conversation spans a spectrum of best practices, illuminating the transformative potential of tailored training solutions. Amidst the discourse, the imperative of measuring training success emerges as a linchpin for organizational growth, with metrics serving as compasses guiding strategic decisions. Yet, beyond the confines of formal training programs, the session underscores the indispensable role of performance support and meticulous documentation in fortifying learning outcomes. Attendees grapple with the challenges posed by generational disparities in learning preferences, navigating a landscape where Baby Boomers, Gen Xers, Millennials, and Gen Zers converge, each with distinct cognitive inclinations. Moreover, the session unpacks the vital significance of on-the-job training, recognizing it as a crucible where theory meets practice, fostering experiential learning and skill mastery. As the session draws to a close, attendees depart armed with insights and strategies, poised to navigate the intricate nexus between training initiatives and organizational efficacy in the ever-evolving insurance claims landscape.

o The Americans with Disabilities Act (ADA) and Family Medical Leave Act (FMLA) have numerous rules and regulations. If the programs aren’t managed appropriately, employers can face legal action, which can be costly. Each year, hundreds of cases are reviewed by the courts. In this roundtable session, we will discuss key learnings from recent lawsuits and see where employers went wrong.

We encourage anyone who works in the disability income claims industry to join this session. Attendees will get to pose the questions they want discussed. Answers may come from the facilitators up front or may come from experts in the audience. We’ll be fully unrehearsed and ready to improvise, taking the questions and the conversation wherever the group wants to go. Participation will be recognized and maybe even rewarded.

In a world where claims and court rulings can range from love stories and comedy to horror and tragedy, LTC insurance law can defy the imagination! Come join a seasoned litigator for this lively discussion about the cutting-edge legal landscape of fraud, waste, and abuse in LTC claims investigation and litigation. You’ll laugh, you’ll cry, you’ll walk away with practical detective skills, a new appreciation for litigation, and valuable insight into how judges and juries view questionable insurance claims. It’s the hottest ticket in town! Plus, CLE credit is being sought for this program.

Cancer is a diagnosis that impacts many directly and indirectly, and with its many forms and stages, often presents complexities in claim management. Balancing empathetic customer service, motivation for returning to work, and understanding where claimants are in their paths to recovery are dynamic for all claims managers. Join us for an interactive session on challenges and opportunities in adjudicating these claims.

In this session we will discuss how claim scoring/claim analytics can impact a claim organization beyond duration management. We will explore how several types of claim scoring/claim analytics models and how the models have impacted the claim organization, including, but not limited to duration management, staffing models, segmentation and allocation of resources.

Join us for an interactive session that will analyze two of the most common and challenging beneficiary scenarios—those claims with a minor or an estate as the beneficiary. We will exchange ideas on how to resolve these claims, including the resources to understand when an estate must go through probate, the requirements for a small estate, and options for payment when the family doesn’t provide the necessary paperwork. We will also discuss the requirements for handling minor beneficiaries—including when a guardian is appointed, UTMA rules, and resources to move these claims along. We hope that you leave with some ideas on how to finalize these challenging claims.

Explore AI advancements, regulatory insights from top legal experts, and real-life fraud case studies in this dynamic session. Join our expert panel discussion featuring a top industry lawyer, data scientist, and fraud program practitioners for a nuanced exploration of technology and regulatory challenges. Elevate your expertise and engage in a lively, interactive discussion on the evolving landscape of insurance fraud detection. Panelists will entertain questions both before and throughout the session to ensure attendees are receiving information needed to take back and improve their organizational approach to these evolving issues.

There are many different types of supplemental health insurance, including vision, dental, hospital indemnity, accident, short-term disability, and cancer. With small face amounts and short benefit durations, claims are often auto adjudicated and plagued with fraud, waste, and abuse (FWA). This session will involve a review of current FWA trends generally associated with supplemental health claims, a discussion around effective strategies for identifying, investigating, and reporting suspected FWA, and concluding with some success stories involving real case studies. Our panel of SIU experts are equally as interested in hearing from you – the audience – so please come prepared for a lively and interactive discussion.

MULTIFARIOUS… Definition: having or occurring in great variety; diverse. That pretty much sums up what we may face in the life claim department! Our claims are multifarious, and the same can be said about the ways we may approach these unique or challenging claims. In this lively session, we will showcase several interesting cases with the participants to draw on the multifarious ways to tackle the claim challenges, irrespective of your level of experience.

In the rapidly evolving landscape of technology, the key to well-organized development and deployment lies in the early engagement of IT professionals. Fostering collaboration between business visionaries and IT experts leads to robust strategies, optimized processes, and diminished risks. This interactive panel session invites you to delve into the synergy of business acumen and technical expertise. Engage with us in a thought-provoking dialogue that illuminates why a partnership between business leaders, subject matter specialists, and IT professionals is essential for the alignment and allocation of appropriate resources and flawless execution of technology projects. Uncover insights, share experiences, and learn from the collective wisdom of our panelists as we navigate the path to superior solution integration.

Summary: Beginning in 2011, life and annuity carriers came under scrutiny by state regulators to audit their life and annuity contracts against the death master file (DMF). Over the last 14 years, the coverage of deaths by the DMF has declined, while the ability to identify “unreported” and “late reported” deaths through alternative data sources has grown. We’ll discuss how the death data landscape has changed, the pain points that exist today, how to address them and reduce false-positives, and turn this audit requirement into a claim’s transformation opportunity. The end goal being to help you improve your claim process and enhance the beneficiary experience.

Join us for a panel that will explore the rapidly evolving Artificial Intelligence regulatory and governance space. Discover how carriers are building specific internal AI governance and oversight. Learn how State regulation and Federal regulation will effect the the internal evaluation and adoption of predictive technologies. And learn from AI vendors what best practices they are pursuing to assure their carrier clients remain at the leading edge of responsible AI.

This is an interactive panel where representatives of Life Claims, UW, Legal, and Reinsurance will showcase life claim scenarios from their areas of expertise and walk through the life cycle of rescissions.

While Artificial Intelligence and other technologies are presently the hot topic in the anti-fraud environment, AI won’t replace the human mind’s ability to rationalize and question the validity of a claim. This presentation will include a lively discussion of real-life cases where the human mind’s ability to question the validity of the insurance claim broke open the case. We will emphasize the claim handlers’ and investigators’ need to ask, “Could this claim have occurred as represented?” and the tools presently available to help answer that important question.

Have you ever presented a case to regulators or law enforcement and have it languish or never know what happened to it? This presentation hopes to demystify the criminal process by providing insights on what criminal investigators and prosecutors look for in making cases and will offer helpful strategies to lead to successful prosecutions. Additionally, the presentation looks at several specific issues prosecutors must overcome and what carriers can do to establish better insurance fraud referrals. The presentation will be interactive, so please come prepared with your thoughts and questions, to ensure you get the most from this session.

The program will dive into the latest case law and cases surrounding group life insurance enrollment responsibilities and liabilities. We also we examine some of the latest authorities in the area of accidental death claims.

Join us for an enlightening panel discussion titled 'Next Generation Claims Handling With the AI Advantage,' where your peers and claims experts will explore the revolutionary impact of artificial intelligence on insurance claims processing. This session will delve into how AI technologies are transforming traditional practices by enhancing accuracy, increasing speed, and improving customer satisfaction in claims handling. Panelists will discuss the latest AI tools and techniques, share real-world case studies, and offer insights into the ethical considerations and future trends in AI deployment within the insurance sector.

Experienced legal counsel will review when rescission may be appropriate, various state prerequisites and requirements and important procedural considerations to be considered in the decision to rescind. The session will provide brief overview of basis rescission requirements and quickly proceed to discussion of advanced considerations.

This session is the ever-popular Fraud Roundtable. We will discuss hot topics such as AI and deep fake, claims fraud trends, red flags and employees with dual employment. Most importantly what are techniques used to detect the fraud. The panel will lead the discussion, and attendees are encouraged to bring topics of interest.