Annual Toronto Fraud Forum

Transcription

1 Annual Toronto Fraud Forum Two Tracks: (1) Insurance Fraud, (2) General Fraud Wide Choice At A Reasonable Cost ASSOCIATION of CERTIFIED FRAUD EXAMINERS Toronto Chapter & CANADIAN ASSOCIATION of SPECIAL INVESTIGATION UNITS Trillium Chapter SPECIAL INFORMATION 1. Early registration $15 discount. 2. Early bird discount date Sept Substitutions accepted anytime. 4. CFE education credits 7 hours 5. RIBO education credits TBA. Premiere Convention Center, Hwy 7 & Leslie WHO SHOULD ATTEND! Investigators forensic accountants SIU staff from insurers internal auditors insurance claims examiners lawyers asset tracers police anti-fraud professionals courtroom evidence specialists corporate security Law firm staff Wednesday, September 30, 2009 (One Day) 8:00am (Registration) to 4:00pm Premiere Ballroom & Convention Center 9019 Leslie Street, Richmond Hill, ON L4B 4A3 Price $180 + GST (Early Registration), $195 + GST After September 22, 2009 REGISTRATION (Fax is recommended): 1. Fax the Attached Registration Form to (416) Visa, MasterCard, Amex 2. [email protected] and then Fax or Phone Credit Card Number 3. Phone (416) (Penny Hill, Administrator, ACFE-Toronto Chapter) 4. Mail: Ms. Penny Hill, ACFE-Toronto Chapter, 88 Fairlawn Ave., Toronto, ON M5M 1S7 5. All cheques should be made payable to ACFE-Toronto Chapter (Banker for this event). 6. Alternate for registration enquiries up to Sept. 8 Tom Eby (416) [email protected] GENERAL ENQUIRIES: CASIU Co-Host Rep: Debbra MacDonald, , [email protected] ACFE Co-Host Rep: Tom Eby, , [email protected] Additional Conference Brochures & Registration Forms: Sample Topic: MOCK TRIAL CROSS EXAMINATION OF FORENSIC ACCOUNTANT Sample Topic: PERSONAL INJURY REHAB FRAUD & ABUSE IN AUTO INSURANCE Page 1 of 5

2 FACULTY and TOPICS (In Order of Appearance) AN INSIDER S LOOK AT FRAUD AND ABUSE IN REHAB AUTO INSURANCE Dr. Robert Reinhart, B.A., D.C., SIU Investigator RBC Insurance Dr. Reinhart is currently an SIU investigator with RBC Insurance. Prior to assuming this role, he served four fourteen years as an independent medical assessor and consultant including 12 years as the Director of a FSCO Designated Assessment Centre. He is a university graduate and has been a licensed Chiropractor in Ontario since Prior to receiving his professional degree, he served for ten years as a police officer. His work as an assessor, clinician, and insurance consultant, coupled with his police background, has afforded him a unique perspective on fraud and malingering in auto insurance Accident Benefit claims. TOPIC (Track 1): Fraud and Abuse in Personal Injury Rehab (Automobile Insurance Claims) This session will look at the fraudulent money making temptations provided by SABS (i.e., the Statutory Accident Benefits Schedule in Ontario) for treatment providers, auto insurance claimants, and ancillary businesses. It will cover the difficulties faced by insurance company SIU s in detecting and combating such fraud. It will also explore the affect such fraud has in terms of the decline in bona fide treatment for parties suffering personal injury, and the increased costs to insurers and society at large. A variety of practical initiatives to curb fraud in rehab will be discussed. MOCK TRIAL CROSS EXAMINATION Ivor Gottschalk, CA.IFA, CBV, Gottschalk Forensic Accounting & Valuations Inc.: Ivor Gottschalk has twenty years experience in financial litigation support. Six years ago Mr. Gotschalk established his independent practice, in Toronto, prior to which he was a partner at an international CA firm. Ivor has lead hundreds of financial litigation support assignments, including high profile matters in Canada and abroad. The Ontario Superior Court of Justice and the Ontario Court of Justice have accepted him as an expert witness. Ivor has been at the core of the development of standards of practice in forensic accounting in Canada since its inception. He is the past Chair of the Standards Committee of the CICA s Alliance for Excellence in Investigative and Forensic Accounting (IFA Alliance). He currently sits on the editorial board of the Commercial Litigation Review. Murray H. Shore, B.A. (U of T), LL.B. (Queen s), Senior Partner Heller, Rubel, Barristers: Murray Shore was called to the Bar of Ontario in He has been designated by the Law Society of Upper Canada as a Certified Specialist in Criminal Law. He represents individuals and corporations as accused or complainants in relation to a wide spectrum of criminal and quasi-criminal offences and related matters in Metropolitan Toronto, Brampton, Newmarket, elsewhere in Ontario and, on occasion, in other Provinces. He is participating in the cross examination of the forensic accounting expert in today s mock trial. Jody Berkes, B.A. (Stanford), LL.B. (McGill), Partner Heller, Rubel, Barristers: Jody Berkes law practice includes the defence of individuals and corporation charged under the Criminal Code of Canada, as well as other Federal and Provincial criminal and quasicriminal statutes. He appears in all levels of courts in Ontario. In addition, he provides legal advice to individuals and corporations on a range of issues relating to criminal and quasi-criminal statutes and regulations. He is a member of the Ontario Bar Association Criminal Law Executive Committee, and is a member of the Criminal Lawyers Association. Mr. Berkes was valedictorian of the graduating class at the McGill Faculty of Law. He worked with the defence firm of Smart & Williams in Vancouver before moving to Toronto in 1999 to work with Heller, Rubel Barristers. His cases have been reported in Ontario and British Columbia. He is participating in the cross examination of the forensic accounting expert in today s mock trial. TOPIC (Track 2): Mock Trial Cross Examination of a Forensic Accountant Were Professional Standards Followed?: You go to court to testify as an accounting expert, with a confident feeling, well prepared on the content of your forensic accounting report. Your testimony is well presented and is drawn out by a friendly lawyer. Then shock. Under cross examination, the first question is about professional standards, not the content of your report. The problem is you have not given much thought to the detail of the IFA standards lately. This session will illustrate the kinds of questions that could be asked and how to respond. This session is a must for all forensic accountants who could be asked to give expert evidence at court. Ivor Gottschalk will play the forensic accountant, ably questioned by lawyers Murray Shore and Jody Berkes. INTERNET ISSUES AND INSURANCE INVESTIGATION TWO SPEAKERS Nawaz A. Tahir, LL.B., Partner Lerners LLP In his legal practice, Nawaz Tahir has assisted his insurance company clients in modernizing claims practices to reflect the use of internet resources as well as adapting to changes in the law. Besides experience at the Superior Court of Justice and the Ontario Court of Appeal, Nawaz handles private arbitrations and cases at the Financial Services Commission of Ontario (FSCO). Among other things, his insurance practice covers accident benefits, personal injury, bad faith claims, SIU claims, and issues like loss transfer and priority disputes. TOPIC (Track 1): Internet Resources and Insurance Loss Adjustment: This session is a must for the modern adjuster. You will come away with a practical internet site reference list useful to the claims adjuster/investigator. Suppose your boss asked you for a quick lowcost webcheck on a claims file. How do you do a webcheck on a file in just a few minutes? This session is perfect for the insurance adjuster/investigator who wants to know the internet steps he or she can take to quickly dig a little deeper into a file that has raised suspicion, is in dispute, has used obscure medical terms, requires usage information for a prescription drug name, needs a quick and dirty present value calculator, Page 2 of 5

3 or a calculator for tax or for inflation, needs camera images, requires a photo of the accident scene intersection, requires wage and salary information, or a lifestyle check on Facebook, MySpace, You Tube, or a resale goods listing on Kijiji. Meredith Jones, LL.B., Associate, Lerners LLP Meredith Jones has been a keen observer of the Facebook phenomenon since it began five years ago. She appreciates Facebook s investigative potential for insurance adjusters, insurance investigators, and law firms. She herself is a bona fide Facebook member. Meredith s areas of legal practice are insurance defense and health law. TOPIC (Track 1): Facebook etc For Insurance Investigation: Insurance adjusters will learn the investigative advantages and limitations of Facebook for assessing the value of a plaintiff s claim for damages both at trial and at settlement discussions. Will learn the legal do s and don ts in accessing Facebook information. The modern adjuster needs to know the Facebook story and the limitations of social networking sites such as Facebook, MySpace, You Tube and Twitter. This session will prove that you do not have to be under 25 to understand the new social networking sites and their usefulness to the claims adjuster/investigator. Two recent court cases dealing with Facebook will also be covered. LEGAL PRIVILEGE & INVESTIGATION A TOUR DE FORCE David Debenham, LL.B, LL.M, MBA, CFE, CMA, DIFA, Partner Lang Michener LLP - David. Debenham is a barrister and solicitor in the Ottawa law office of Lang Michener LLP. There is an interesting difference in David s profile in terms of his business and accounting qualifications, as well as his forensic accounting training in the DIFA program. David is a rare bird, a lawyer having full accounting credentials and an overlay of forensics. He is a forensic investigator s delight, someone who talks the language of the forensic expert witness and empathizes with the risks and pitfalls of investigation from all its various perspectives. TOPIC (Track 2): What Every Forensic Accountant & Investigator Should Know about Legal Privilege: A tour de force on the subject of privilege, this session will help demystify legal privilege for the forensic accountant/investigator. When you leave this session, you will be able to properly plan and prosecute any investigation into any form of intentional wrongdoing, be it fraud or otherwise, without having to be concerned that a fraudster s claim to privilege might prevent you from acquiring relevant evidence. After an investigation begins, fraudsters usually attempt to claim privilege in order to cloak their improper conduct. Contrary to conventional wisdom, fraudsters cannot assert privilege to impede a properly conducted fraud investigation from acquiring relevant documentary or electronic evidence regardless of where such evidence may be found, including a lawyer s file. Even lawyers may be forced to testify against their clients in such circumstances. It is critical for every forensic accountant, investigator & expert to understand the parameters of privilege, and conduct their engagements accordingly. KICKBACKS AND PURCHASING FRAUD Cameron A. McCaw, CA, CFE, Forensic Accountant, - Seneca College - Cam has been an investigative and forensic accounting practitioner for over two decades. His forensic work has included the investigation of financial misconduct and corruption, the quantification of damages, implementation of anti-money laundering programs, tracing and recovery of illicit gains, and various due diligence investigations. As well, he has been involved with several significant computer forensic engagements. Earlier in his career Cam was a partner in an international accounting firm and spent a number of years with a major Canadian bank. Cam is currently a Professor at Seneca College in the Certificate Program in Fraud Examination and Forensic Accounting. TOPIC (Track 2): Kickbacks and Purchasing Fraud: One of the main types of fraud shared by governments, NGO s, and businesses is a form of corruption known as kickbacks. Kickbacks are generally considered improper payments to an employee in exchange for steering business to or controlling prices for a particular third party supplier of goods and services. Kickback investigations are often complex, primarily because the direct evidence is usually outside the company. As a result it requires significant circumstantial evidence to support allegations of fraud. This session will provide insights into how to identify kickback situations, how to approach them from an investigative perspective, and how to prevent them. ABC S OF FRAUD Microphone Personalities, Crime Prevention Awareness Program: ABC s of Fraud: The ABC s of Fraud program, created by the Volunteer Centre of Toronto in 1996 and later carried on by the Crime Prevention Association, targets older adults through clubs such as investment clubs, social groups, senior centres, libraries, church groups, senior housing facilities, and retiree groups. Over 1,700 presentations have been made to over 54,000 people. As a result, fraud committed on seniors has declined significantly, as reported by police spokespersons. Luncheon TOPIC (Both Tracks): How to Avoid Phone Scams, Swindles, Hoaxes, Identity Theft, & Internet Fraud: During this live and in person radio show, volunteer speakers or animators, use interactive techniques such as skits, quizzes, and discussion to involve the audience in the learning process. It is very enjoyable and incredibly informative. This show rates a standing ovation. It is scheduled for the noon hour luncheon plenary session, so everyone can enjoy and learn at the same time. Page 3 of 5

4 WORKSHOP FRAUD & DIRTY TRICKS AUTO INSURANCE Cecil R. Jaipaul, FCIP, FLMI, FLHC, ARM, AIRC, CFE, President Jaipaul Consulting For over ten years Cecil Jaipaul has been doing insurance compliance and consulting work with a focus on statutory accident benefits claims (SABS). Previously he was employed by the Financial Services Commission of Ontario (FSCO) for over seven years doing compliance projects in auto insurance, He and his staff currently focus on SABS consulting to general insurance companies in Ontario. TOPIC (Track 1): Service Provider Driven Claims and Fraudsters in Auto Insurance This is a workshop that takes an in-depth look at how investigations are used to combat accident benefits fraud in auto insurance. It will look at loopholes, dirty tricks, systemic abuse, and issues of non-compliance created by fraudsters and others in the gray area. It will also reference what remedial action is available in the Report on the Five Year Review of Automobile Insurance and any resulting legislation. DAMAGES QUANTIFICATION PROFITS VS. VALUATION Wayne Rudson, CA.IFA/CBV, ASA, CFE, President Rudson Valuation Group Inc. Wayne Rudson has been involved in business valuation, litigation support and forensic accounting since He has valued over $1 Billion worth of assets, authored over 500 valuation reports, and has been involved in over 200 breach and intellectual property disputes with damages ranging from Nil to $150 million. He has served as an expert witness over 25 times before the courts and before other tribunals. TOPIC (Track 2): Damages Quantification - Reconciling Lost Profits to the Value of a Business: This session will review the relationship between damages for lost profits and the value of the business suffering the alleged loss. It will cover both the similarities between the two calculations and the differences, so that the professional assessor can reconcile the two approaches to improve the quality of expert quantification reports. When you leave this session, you will be aware of alternative methods to quantify damages and be alert to issues being raised by Canadian courts in such cases. This sort of topic is rarely presented and will appeal to professional accountants, insurance adjusters and legal counsel. CANADA S BEST KNOWN VISUAL EVIDENCE CONSULTANT Elliott Goldstein, B.A., LL.B, Lawyer and Canada s Best Known Visual Evidence Consultant. Mr. Goldstein is the author of the well known Visual Evidence: A Practitioner s Manual, first published in 1991 and updated twice yearly since then by Carswell Legal Publishers (now Thomson Reuters). It has grown to two volumes and covers insurance surveillance (e.g., suspected malingering plaintiffs and WSIB claimants), criminal suspect surveillance, casino surveillance, workplace surveillance, motor vehicle accident reconstruction videos, etc. Elliott has published over 130 articles on the topic of videotape and photographic evidence. He teaches the law portion of the Applied Forensic Videography Course at the Ontario Police College at Aylmer, Ontario. He gets involved in the entire video production world, including producing videos of views of accident scenes, the selection of pictures of plaintiff s injuries, advising on day-in-the-life videotapes for plaintiffs and defendants. He regularly consults to the alarm and security industry. TOPIC (Both Tracks Together): Forensic Video, Digital Images, and the Law: This session will be a tour de force of the forensic aspects of surveillance videotapes including clarification (enhancement) of digital images, downloading images from digital video recorders, and the identification of unknown persons using points of comparison. Surveillance videotapes will be shown. You will come away with an understanding of the Charter, the Criminal Code, and PIPEDA (the federal privacy act), chain of custody issues, and the rules governing admissibility and the weight of visual evidence. Very useful, practical and applied information for insurance adjusters, insurance investigators, private investigators, legal counsel, forensic accountants, human resource staff, police officers, judges, and security managers of all kinds. Extra copies of this brochure and the registration form can be obtained by downloading a PDF file from the following websites and The best way to register is to fax your registration form to (416) Registration enquiries can be made by to [email protected] at any time, or by phone (416) to office administrator Penny Hill. Conference Co-Chairs can be reached as follows: Call Tom Eby (ACFE Host) at (416) or [email protected] ; or call Debbie McDonald (CASIU Host) at (289) or (905) or [email protected]. Choose the speakers and sessions that interest you from either Track 1 or Track 2. You are not limited to just one track. Substitution by a colleague is allowed at any time. Take advantage of the early bird $15 discount by registering early up to and including Tuesday, September 22, Page 4 of 5

5 Annual Toronto Fraud Forum Jointly Sponsored By Association of Certified Fraud Examiners, Toronto Chapter Contact: Tom Eby, Penny Hill, Tel. (416) , Fax (416) Summer Contact (prior to Sept. 8) Tom Eby: (416) , Canadian Association of Special Investigation Units, Trillium Chapter Contact: Debbra MacDonald, Tel. (905) , Registration 8:00am (coffee & muffins) - Lunch included Finishes 4:00pm Wednesday, Sept. 30, 2009 Premiere Convention Centre, 9019 Leslie St., Richmond Hill, (Hwy 7 & North on Leslie), Tel # TRACK 1 Insurance Fraud # TRACK 2 General Fraud 8:00am Registration Coffee, trade show. 8:00am Registration Coffee, trade show 1 8:30am Rehab Claims Auto Insurance Fraud & Abuse - Dr. Bob Reinhart, D.C., RBC Insurance SIU 1 8:30am Mock Trial - Forensic Acctg Stds Ivor Gottschalk CA.IFA, Murray Shore, LL.B, Jody Berkes, LL.B 9:45am Coffee break & trade show (20min) 9:45am Coffee break & trade show (20min) 2 10:05am The tricks of Internet Use for Insurance Claim Investigations Nawaz Tahir, Lerners Law Firm 2 10:05am Legal Privilege and Forensic Investigation - David Debenham, LL.B, Lang Michener LLP 3 11:15am Using Facebook etc. for Ins. Claims 3 11:15am Kickbacks & Purchasing Fraud Meredith Jones, Lerners Law Firm Cameron McCaw, CA, CFE 4 12:00pm Lunch ABC s of Fraud Crime Prevention Association 4 12:00pm Lunch ABC s of Fraud Crime Prevention Association 1:40pm Mini break (10 minutes) 1:40pm Mini break (10 minutes) 5 1:50pm Service Provider Driven Claims and Fraudsters in Auto Insurance Cecil Jaipaul, FCIP, FLMI. 5 1:50pm Damages Quantification Lost Profits vs. Business Valuation Wayne Rudson, CA.IFA/CBV 2:50pm Famous Cookie Break (10 min) 2:50pm Famous Cookie Break (10 min) 6 3:00pm Surveillance, Digital Images, Court Prep, Privacy, by Visual Evidence Consultant Elliott Goldstein, LLB 6 3:00pm Surveillance, Digital Images, Court Prep, Privacy, by Visual Evidence Consultant Elliott Goldstein, LLB 4:00pm End of Conference 4:00pm End of Conference Registration (Please Print) Fax to (416) Please add 5% GST to your fee. Name Standard fee $180 Position Late registration fee Company after Sept. 22, 2009 $195 +5%GST Add $9.00 GST#R %GST Add $9.75 Address City Please - all cheques payable to ACFE Toronto Chapter and remit to: Prov. Postal Code 88 Fairlawn Ave., Toronto, ON M5M 1S7 Tel Fax VISA, Master Card, Amex - Number Signature for credit card Card Expiry: Mo. Yr. Page 5 of 5