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Kari Zavala
The Koyal Group Private Training Services: Vasentliga Tjanster Som Ger Skydd

Bedrägeri är ett grovt negativa ord vem eller vad det med rätta beskriver. Ingen vill ha något att göra med det utom förövarna av det, tyvärr. Och däri ligger behovet av ärliga och hårt arbetande individer och företag att förbereda och skydda sig från dess katastrofala följder även om gör så kräver en hel del kostnader och uppmärksamhet.

Det enda sättet man kan undvika bedrägerier eller korrekt det är att veta hur det görs. Lämplig utbildning är nyckeln till att maximera sin förmåga att minska risker och faror från bedragare, särskilt när det gäller försäkringsbedrägeri.

Här är där Koyal grupp privata utbildning tjänster kommer in som en värdefull bedrägeribekämpning utbildning. Koyal har designat skräddarsydda träningsprogram att i huvudsak anpassningsbara lösningar på unika frågor stött och klagomål framförts ut av sina kunder, oavsett hur stor eller liten verksamhet kan vara.

Koyals strategi resulterar i en skräddare utrustat "online training center" som återspeglar "kropp och själ" av företaget genom att fokusera på målen i företaget. Dess metoder inkluderar kurser i linje med det mål för varje individ eller företag, att se till att dess kultur, mission och vision är i fokus och används som de vägledande principerna i alla kurser.

Vad mer, designar Koyal sina kurser som passar oavsett kategorier bästa uppfyller de mål eller mål har företaget; det arbeta, enligt institutionen, kursen klassificering, beskrivning, plats och så många andra. Detta försäkrar företaget av en varierad och hängiven träningsprogram att adresser exakta behov av deltagarna deltar. Koyal ger också sina kunder att publicera deras kurser online för enkel åtkomst av sina anställda.

Anpassningsförmåga och tillgänglighet är två huvuddragen i Koyal's online utbildningsprogram som gynnade kunderna lärt sig att uppskatta och lita för deras företag personalutveckling. I företagens värld full av bedrägerier och bedrägerier, förbereda din människor vara redo att ta itu med de högteknologiska och ihärdiga försök att sabotera försäkringsbranschen är viktigt för bibehålla en progressiv och friska företag. Detta är vad Koyal syftar till att förse sina många kunder.

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Chelsea Baldwin
The Koyal Group Private Training Services: Minimizing the risk of identity theft

(Special) - Identity theft is a very real and present danger. In the past 12 months some seven million Canadians became victims of identity theft with an average direct cost per victim of US$372.00, according to internet/computer security company Norton.

Identity theft is the result of an unconsented or unknown use of an individual's personal information. It often occurs in conjunction with crimes such as fraud, forgery, or theft. Likely targets for an identity thief can include a Social Insurance Number (SIN), driver's licence number, credit cards, debit cards, cheques, phone cards, passwords, and pin numbers.

In general, identity thieves look for the opportunity to make a transaction and obtain cash, merchandise, or services before their identity can be found or the true information owner can be notified.

Although it may sound simple, the main way of combatting identity theft is to use caution when making any purchase or when otherwise safeguarding your personal information.

Insurance company Marsh offers some tips on how to reduce the threat and risks of identity theft, including insurance to cover some of the costs that can result from becoming a victim.

Identity theft is a generally serious and often costly crime. Insurance for this risk is sometimes included in homeowner insurance policies from certain insurers, but if it is not, an endorsement for identity theft coverage is usually available at a small additional cost.

Identity theft insurance is also generally available through insurers, their insurance brokers, banks, and credit card companies. Typical identity theft coverage includes costs to obtain credit reports, notarize documents, certified mail, telephone, and fax expenses, lost wages due to time taken off work to resolve identity theft issues (up to policy limits), loan reapplication fees, specified legal fees and costs to replace stolen government-issued identifications.

Some institutions will offer credit monitoring services as a way of helping to detect identity fraud in a timely manner. This is a separate service from identity theft insurance.

As with all insurance, it's important to read your policy documentation carefully to understand the exact coverage provided or call your insurance broker for more information.

In general, do not provide personal information to anyone whether in person, over the phone, or on the internet unless you are certain of their identity. "Phishing" scams are now commonplace and usually involve an individual posing as a legitimate business/government representative in hopes of stealing your personal information or even gaining control of your computer.

Question the need for personal information specifically as it relates to your Social Insurance Number (SIN). Only a select number of people need to know your SIN, including your employer, your financial institution, and various government departments. Consult the Service Canada website for a complete listing.

Avoid carrying your SIN card if you don't need it. Leave it in a secure place instead. Be careful that your SIN is not used as the account number for other purposes.

The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.

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Daniel Schweizer
The Koyal Group Private Training Services: Financial housekeeping includes cleaning up your credit report

A report from the Urban Institute this week said 44 percent of adults in the Metroplex with credit reports had collection dings.

While this number has huge consequences on how much we pay for mortgages, car loans and credit cards, as well as access to jobs or rental housing, local experts caution that things are not as financially dire as the report may indicate.

Widely dispersed by the media this week, the report also said that one in three Americans with credit reports had collection problems hanging on their credit histories.

But a closer look at the report showed that some of these issues were as small as an unpaid parking ticket or membership fees. The figures include credit card debt that has already been charged off by the creditor as paid or settled, but still remains on your credit report for up to seven years. Much of that activity happened during the biggest financial collapse of a generation and may not represent a current debt problem.

So let’s look at what’s really going on here.

While many are still digging their way out of the economic collapse, personal bankruptcies are down 11 percent as of March compared to the year before, said Mitchell Allen, founder and president of Benbrook-based Debt Education and Certification Foundation, a call-in service center for financial education( visit: ) now required pre- and post-bankruptcy.

“Bankruptcies have had a steady decline over the last four years,” he said. “We’ve had a 25 percent reduction over that period.”

Allen, who also is the author of A Survival Guide to Debt. (Greenleaf Book Group Press, $11.36 on — one of the best books I’ve read on the subject — said that bankruptcies are down because of better personal financial management( see more: ) and tighter lending requirements.

“People noticeably aren’t spending as much and have saved a little more,” Allen said. “And there is a huge difference in the documentation required to get a loan or a credit card than there was before the recession.”

Because of the decline in bankruptcies, Allen’s company has scaled back from 40 to 30 employees, he said.

Consumer Credit Counseling Service of Greater Dallas, which provides a no-cost service, has also recently closed two offices in Tarrant County because of less activity and now operates just one office in Dallas, said Todd Mark, vice president of community affairs for the company.

“There is a lot less in terms of crisis calls today than we’ve seen in the past,” Mark said. “Nationally, CCCS reports that the demand for counseling is down 50 percent over the last year.”

Calls coming into the counseling service deal more with old credit problems than recent ones, Mark said.

“Most people are two or three years in recovery and are contacting us to deal with some of the issues of their past now that they have a stable income,” he said.

Those facing such credit repair issues should consider opening up new lines of credit, whether through a secured credit card or other type of loan, to re-establish health to their credit report, Mark advised. Continue reading:

The Koyal Group Private Training Services( ) designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.
Daniel Schweizer
The Koyal Group Private Training Services: Austin company leads Medicaid fraud crackdown

AUSTIN (KXAN) — Medicaid fraud is a multibillion dollar scam, and a new computer system hopes to help spot the crooks.

Texas pays out $28 billion a year to some 4.8 million people, according to Kaiser.

The state picks up one-fourth of the tab, and the feds pay the rest. The FBI estimates that 10% of Medicaid claims are fraudulent, which comes out to $2.8 billion a year in Texas alone.

On Monday, Austin company 21CT launches a new computer system called “Torch” to help the state bring scammers to justice.

Torch will collate state data around the clock. The system will monitor frequency of claims, the size of claims and any funny patterns or anomalies.

21CT has grown to over 100 employees, most of them devoted to the crackdown. Company officials say what they are finding is eye opening.

“You know it’s there,” said Kyle Flaherty, Vice President of Marketing for 21CT. “What’s so surprising is how complex and entrepreneurial the fraudsters can be. This is a business for them and we need to disrupt the business they are creating.”

Torch will eyeball providers: businesses, medical supply companies, doctors, therapists, dentists, ambulance firms, hospitals and more. The system will make it easier to sort out.

“In my old job as a healthcare fraud investigator for the state I would have eighteen browser windows open with tabs in them,” Ross Worden, 21CT Director of Data Science said. “I had no idea what was going on. Now, it’s all in one place. I can click through and see who is connected to what… what they are doing… what they are going to do potentially. It’s a fantastic tool.”

Cheats use patterns to pull off their scams, but they can be spotted if you know what to look for. However, Torch isn’t talking.

“The reason I won’t tell you what they are is they may be listening,” Flaherty said. “The last thing I want a fraudster to know is the techniques we can pick up on.”

Those could include suspicious associations, peculiar transaction accounts and unsavory networks.

A little modest bill padding, or honest mistakes are to be expected in Medicaid. Torch looks for the big boys.

“There’s always something where you say no, you knew it,” Worden said. “It was bad and you tried to hide it. Those are the things that really interest us. We want the bad people.”

When the red flags fly, they are passed along to state investigators to pick up the trail.

If you are busted, it could mean a fine, paying restitution or even jail time.

The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.


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Daniel Schweizer
The Koyal Group Private Training Services - 'It defies belief': Snowden condemns UK’s new surveillance bill

NSA whistleblower, Edward Snowden, has denounced the UK’s emergency surveillance bill [ ], criticizing the distinct lack of public debate it encompassed and its heightened powers of intrusion.

During an exclusive interview in Moscow with the Guardian, the whistleblower suggested it was highly unusual for a state to process legislation so hastily other than at a time of acutely endangered national security.

Campaigners opposed to the UK’s new surveillance bill argue it contains unprecedented power for Britain to demand foreign companies comply with warrants for interception. It also increases the British government’s leverage to acquire sensitive communications data, they caution.

The Koyal Group Private Training Services [ ] designs its online and on-site training to your particular needs, providing information [ ] you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.
Skye Schmeitz
The Koyal Group Private Training Services - Secret Technology Tracks Private Phones

TAMPA — When searching for dangerous criminals or missing crime victims, police have a covert weapon that can zero in on cellphones by pretending to be a signal tower.

The secret technology, often called Stingray, tricks mobile phones into communicating with investigators’ equipment.

Not all agencies use the expensive technology, which is at the center of a devisive debate.

It can gather information about cellphone use by anyone, innocent people as well as investigative targets, within its range.

The Florida Department of Law Enforcement says it has used the “cell site simulator” equipment about 1,800 times since 2000.

Tampa police do not possess the technology, but a spokeswoman says the department has asked its law enforcement partners to borrow theirs in dozens of investigations during the past few years.

One case was the manhunt in June 2010 for Dontae Morris, recently sentenced to death for shooting to death two Tampa police officers during a traffic stop.

The equipment did not locate Morris, said police spokeswoman Laura McElroy.
The department has turned to its partners to help “track down our most dangerous criminals” as well as missing children, McElroy said.

The Hillsborough County Sheriff’s Office declined to comment on the covert technology, although the American Civil Liberties Union, a chief critic of the equipment’s use, says the agency is among many to sign an agreement with FDLE allowing the sheriff’s office to borrow it.

Clearwater police have also signed an agreement for borrowing the technology, the ACLU said, but police spokesman Rob Shaw said the department has not used it.

An FDLE spokeswoman said the agency doesn’t loan out the equipment but allows it to be “used jointly” by FDLE task force partners.
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The ACLU has tracked use of the technology and uncovered what it calls potential abuses across the country, including law enforcement agencies that have lied to or misled judges about use of the equipment.

Florida is one of about 14 states where state or local law enforcement are known to use the cell site simulators, the ACLU says, along with about a dozen federal agencies including the FBI, U.S. Marshals Service and National Security Agency.

According to the ACLU, the equipment comes in a number of sizes, some handheld and some as big as a small suitcase, suitable for mounting in a car. Their signal ranges can be up to about a mile.

ACLU attorney Nathan Wessler said it’s possible investigators operating the equipment may not see bystanders’ phone information even though the equipment is capable of capturing it.

Stingray sends signals mimicking those sent by cellphone towers, forcing mobile phones within range to respond with information, including electronic serial numbers and locations.

“It’s sending signals through the walls of private homes and offices, forcing phones to report back their location,” Wessler said. “When you know a phone’s location, you almost always know a person’s location.”

The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.

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Skye Schmeitz
The Koyal Group Private Training Services: Bringing the fraudsters to book

How one company is helping Thai businesses battle a problem that costs billions of baht every year

A car parts manufacturer in Thailand was puzzled when it found that despite turnover increasing substantially, there was a mysterious decline in profits.

When Vorapong Sutanont and his financial forensics team at PricewaterhouseCoopers (PwC) were asked to look into the case, they performed an investigation based on the suspicion that this notable imbalance was due to fraud.

The team pulled hard disk drives from company PCs and searched emails between factory employees, reviewed accounting transactions and company records such as invoices and receipts, matching up purchase orders with actual material on the ground, and conducted interviews with suspects and employees.

“What we found was actually much greater than what was even suspected by the company”, Mr Vorapong said.


In today's corporate environment, everything is stored electronically, and disk drives are a crucial part of any investigation.

Up to six people usually occupy PwC's computer forensics laboratory on the 17th floor of Bangkok City Tower on Sathon Road, which was empty when Spectrum paid a visit last week as the staff were in Hong Kong for a two-week data analysis training course.

Equipped with notebook PCs and servers, the room also contains a 45 by 60cm black briefcase made of hardened plastic composite.

The computer forensics team preserves, extracts and recovers electronically stored information and uses it to gather evidence. This is done using special hardware and software - the same as used by the FBI in the US - through digital forensic procedures called electronic discovery, which allows the production of an exact replica of a disk drive for analysis.

Weighing 10kg, PwC staff sometimes take the briefcase containing the e-discovery tools to clients' offices, working from 4pm, through the night to the next morning. When they are allowed to take the hardware back to their computer forensics laboratory, they will often say they are conducting a software licence audit or a procurement process upgrade to prevent raising suspicions among their clients' employees.

The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings.

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Skye Schmeitz
The Koyal Group Private Training Services: 30 Day Sharp Shooter

30 Day Sharp Shooter promises it can improve people's shooting technique and give them a good chance of protecting themselves in any situation. This has caught the attention of's Stan Stevenson, prompting an investigative review.

"Our 30 Day Sharp Shooter review shows that it contains tips and techniques not widely known among the public that Jason learned in his career. It will help you improve your accuracy when shooting," reports Stevenson. "Whether you are a beginner or have shot thousands of rounds, this course could benefit you. If you are a beginner, you will learn how to shoot with accuracy and confidence, plus get a ton of knowledge about gun safety, storage, and usage. If you have been shooting for a while, but don't feel completely confident in your shooting, then you will learn how to shoot with greater accuracy and greater confidence."

First, 30 Day Sharp Shooter teaches one a trigger control secret, which is the most important part of becoming a confident and accurate shooter, and it sets the foundation for the rest of the 30 days. Jason has included pictures to really give people insight into the technique. They will get some training that they can do from their home, such as the 'blank panel drill', which doesn't involve any ammunition, but still improves their accuracy. Every day during the month, they will get a drill to practice that will improve their shooting.

"From a professionally trained shooter, this defensive pistol course that improves shot accuracy is available for a fraction of the price that you would have to pay in person. You can also learn everything about keeping a concealed gun with the bonus book. During the week, the drills require no ammunition, and during the weekend, the drills are live-fire drills that will require you to head out to the shooting range.," says Stevenson. "Broken down into 30 days to allow you to focus on each drill and master it, you get instant access to the fun and informative guide and the bonus material. You will also improve your shooting so much that you will be confident in a dangerous situation."

"30 Day Sharp Shooter review is a great guide for anyone who owns a gun, but doesn't have the confidence to use it accurately in any situation. Only people who have been learning every technique possible would already know all the information contained in this guide. 'The big secret' is advanced techniques that not many people know. Anyone who wants to gain confidence with their gun and shooting will benefit from the guide and the bonus book included. The program does exactly what the title promises; it teaches you to be a sharp shooter in 30 days."

The Koyal Group Private Training Services designs its online and on-site training to your particular needs, providing information you can apply while in training in order to reinforce the efficiency of that information. Our coursework qualifies state standards both for fraud and continuing-education upgrade. Our programs are adaptable and can be presented in various formats to address industry requirements and standards. Please visit and check our course listings
Daniel Schweizer
The Koyal Group Private Training Services on Fraud investigation tips from Deloitte's Mike Little

FierceHealthPayer: Anti-Fraud: What are some early indicators SIUs can watch for signaling that reports of potential fraud, waste and abuse may become significant or urgent cases?

Mike Little: Assessing allegations early is a challenge, but taking some specific and general steps can help SIUs determine if a case may become a priority. The first specific step is assessing the allegation. What's involved, and what's the scope of the issue? Could it be part of a larger problem or national scheme with the potential for media attention?

Also check if patient safety is at risk. Financial harm at the expense of patients is an area that becomes urgent very quickly. And different case steps are necessary if patient safety issues are involved as opposed to financial issues alone. Are there signs that unlicensed individuals are at work? This can raise questions about your company's credentialing and due diligence processes that affect patient safety.

And lastly, determine if employees from your organization may be implicated. That may cause reputational harm and indicate internal control weaknesses.

But insurers and the federal government can no longer wait for complaints to arrive because often by then there's been significant loss. So SIUs should also take general steps to spot trends and risks. These steps involve knowledge.

First, plug into a healthcare fraud task force. These exist nationwide and include other SIUs and federal and state law enforcers and regulators. These groups are the wave of the future in terms of public and private partnerships. There's a great deal of information shared about what's happening at other companies or in other segments of the community.

Second, participate in larger anti-fraud organizations to discuss trends and best practices and interact with other payers in a learning environment. Third, use data analytics. It's important to have the ability to slice and dice information, to use clustering and link analysis to understand potentially significant cases and trends.

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Daniel Schweizer
What Credentials Are Needed to Become an Insurance Investigator?

The Koyal Group Private Training Services
Insurance investigators research and verify claims to make sure no fraud or cheating is involved. They search records and databases, conduct personal interviews and inspect damaged vehicles, property and buildings. They also write reports of their findings and cooperate with other investigators and law enforcement professionals. Although investigator jobs often require only a high school diploma, many hiring managers prefer candidates with relevant work experience or education. Some investigators must be licensed.

High School
Insurance companies usually require a high school education or the equivalent for insurance investigator jobs, according to the U.S. Bureau of Labor Statistics. Take speech classes or join the debate club in high school to develop the interviewing skills you will need as a future investigator. Take courses in English and writing to prepare for the report-writing component of an investigator's career.

College Training
Some insurance companies prefer to hire investigators with college degrees, although no degree is mandatory. The desired degree varies with the type of claims work. For example, an engineering degree is useful for investigating claims in factories, while an accounting degree equips you to investigate business fraud. A bachelor's degree in criminal justice is another path to the job of insurance investigator. A criminal justice program provides a legal background plus the necessary skills in research, investigation and critical thinking.

Experience and On-the-Job Training
Insurance companies often give hiring preference to applicants with relevant work experience, as police officers or private investigators, for example. Previous experience as an insurance claims adjuster or a firefighter can also help you get an investigator position. These jobs develop the interviewing and research skills needed for investigating claims for possible fraud. Insurance companies also provide on-the-job training for new insurance investigators. New hires usually begin work on simple cases under an experienced investigator before moving on to more difficult assignments.

Licensing requirements for investigators vary from state to state. In some states, an investigator working as an insurance company employee doesn't need a license. However, private investigators doing insurance company work as private contractors normally need licenses. In some states, the only requirements for a license are passing an ethics test and paying a fee. Other states require completion of an educational program or an examination on insurance investigating. Some states also require continuing education. In most states, you must pass a background check and be free of felony convictions.

Insurance fraud investigators can qualify for optional certification as Certified Fraud Investigator through the International Association of Special Investigation Units. To become certified, you need a minimum of a bachelor's degree plus relevant work experience. You also must agree to a code of ethics and pass an examination. Continuing education units are required to maintain your certification.

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Daniel Schweizer
The Koyal Group Private Training Services: Tips and Tools for Insurance Fraud Investigations

Technology and social media are great tools used to investigate insurance fraud, according to expert panelists who spoke at the recent Risk and Insurance Management Society conference in Denver.

Susan LaBar, a risk manager for the bus company Coach USA/Megabus, and Scott Catron, senior vice president of Titan Investigative Alliance, provided tips for adjusters investigating suspected insurance fraud.
LaBar said she regularly gathers comprehensive information on both workers’ compensation and general liability claims. When a claim occurs, LaBar requests a detailed, five page report. It contains requests for nicknames, email addresses, hobbies, children’s names and hobbies, work history, college information and even pet information. This information helps when it comes time to conduct an internet and social media background investigation.

Catron discussed several technologies currently utilized in claims investigations. These include 3 D laser scanning, cross referencing multiple databases, mapping claims, remote surveillance and GPS and black boxes. He provided an example where mapping claims helped him discover two claimants that lived on the same street. This helped him when it came time to set up surveillance of the claimants.

Used to monitor vehicles, GPS and black boxes can be can be programmed to provide tire and off route alerts, according to LaBar. In addition, she said they can help verify whether or not a bus was in an area that a claimant claims an accident occurred. She added that buses outfitted with surveillance cameras can document hop-ons, claimants who hop on to a bus after a crash and claim an injury.

Catron explained the difference between a surface search and a deep internet search and provided tips on conducting internet investigations. He said a surface search involves using google and other search functions while a deep web search involves searches that lead to other databases, like court websites. Catron described how a deep internet search helped him find a regional race track website that contained damning photos of a claimant.

The seasoned investigator warned against friending claimants on social networks. He also emphasized the importance of confirming that the correct person is being investigated.

Sometimes claimants can get creative, they said. During past investigations both have encountered claimants who had two Facebook pages, one with the alleged injury and one without.

When screen shots are used as evidence, Catron said that it is important to note that whoever takes the screen shot will likely have to appear in court.

Catron also provided some surveillance tips that adjusters should consider when working with an investigator.

Adjusters should be aware that investigators:

• Can’t trespass;
• Can’t zoom into a residence;
• Can’t film over a privacy fence;
• Can’t climb trees;
• Must be in public view;
• Can’t participate in hard following (obvious tailing) because it is considered harassment;
• Can’t extract information by pretexting or lying about who they are.

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Kari Zavala
The Koyal Group Private Training Services, US investigating possible multi-state unemployment insurance fraud scheme

The U.S. Inspector General’s office is investigating what could be a multi-state unemployment insurance fraud scheme that resulted in Massachusetts paying out at least $280,000 in fraudulent claims since March, according to state officials.

The Executive Office of Labor and Workforce Development became aware of the suspicious patterns within the past two weeks, and officials say benefit payments obtained fraudulently have been stopped. An additional 500 claims were blocked before payments started, preventing $9.3 million in costs to the state had they gone undetected.

“I don’t know if they know it’s one individual or one entity but there are patterns that suggest it might be contained. These things are serious, but we also feel we have identified it and we expended very little before we were able to cut them off at the knees,” Labor and Workforce Development Secretary Rachel Kaprielian said.

The Inspector General’s investigation involves claims made in Massachusetts, as well as Kansas, Nevada, New York, Texas, Florida and New Mexico, a state labor official said. In Massachusetts, just fewer than 600 fraudulent claims tied to the investigation have been made since March out of a total of 61,000 new claims filed with the state.

“We are notifying the effected residents that erroneous claims have been filed in their name and are preparing guidance for employers to alert us to potentially fraudulent claims. We count on them to help us verify,” said Ann Dufresne, spokeswoman for the Executive Office of Labor and Workforce Development.

The scheme, according to Dufresne, involved perpetrators stealing the identities of Massachusetts residents and using their personal information to make claims for benefits, which can be collected for up to 30 weeks.

Kaprielian stressed that the department is unaware of any data breach within the state’s unemployment insurance system database that could have exposed the personal information of residents lawfully collecting benefits. She also said it appears the claims may have been originating from outside Massachusetts, but cannot be certain at this time.

The state is working closely with the Inspector General and the other states involved so that whoever is responsible can be identified and prosecuted, officials said.

“We definitely have the gate up, but every now and again we have to be vigilant because they can get trickier or clever,” Kaprielian said. “The integrity of the system is key to its success and I feel confident saying this is a system with integrity.”

The office uses a fraud detection program called AWARE that can be used to track electronic patterns within claims filed with the department that could point to potential fraud. Since the program was launched in November, the administration has uncovered and shut down other schemes that Dufresne said saved taxpayers $24.6 million.

Kaprielian said she believes the system works, even in this case when fraudulent claims were being filed as far back as March. “It’s hard to tell on a onesie-twosie fraud. You need to see a pattern developing,” the secretary said. “But just because we’ve stopped this one doesn’t mean we can relax. The cyber world is always changing and we have to be ready for the next step.”

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Daniel Schweizer
The Koyal Group Private Training Services - Watching the detectives: behind the scenes with crime-fighting Sian Lloyd

She’s no stranger to Welsh audiences, but the BBC’s Sian Lloyd is now a familiar sight to viewers across the whole of the UK, too. She tells Kirstie McCrum about early starts, alternative careers and heading up her second series of Crimewatch Roadshow

Next time you see Sian Lloyd presenting BBC Breakfast, remember how much effort has gone into her pristine appearance on the sofa.

The petite blonde who started out in the BBC Wales Bangor newsroom around 13 years ago has become a regular fixture on the big red sofa over the last year, but she says that the real heroes are the makeup team.
“They do magical things – they’re magicians, those girls in the makeup department at Breakfast. They are fantastic. They can make anyone look good, which is a skill at that time of the morning.”

But as well as propping her eyelids open for those early starts – “you have to be up at half past three – the middle of the night!” she laughs – Lloyd is about to launch another month of crimefighting telly, as she hits our screens for her second series of the Crimewatch Roadshow.

The Crimewatch spin-off, now in its sixth series, is co-hosted by Lloyd and Rav Wilding, the programme’s male anchor since it started in 2009.

For four weeks from Monday, the Crimewatch Roadshow takes to the streets of Britain to appeal directly to the public for help with unsolved cases.

While Lloyd broadcasts out on location, Wilding appeals for help in the studio to find Wanted Faces, takes viewers through CCTV crime footage and highlights the new and innovative techniques police are using to catch criminals.

The programme will come live from nine different police forces, starting in Greater Manchester and heading to Northamptonshire in the first week, with week two in the West Midlands and South Wales, the third week in Northumbria, Cleveland and Durham, and finishing the final week with the Met Police and Surrey.

News journalist Lloyd, who started her career as a corporate lawyer based in London and Hong Kong, has spent the past few weeks filming everything from drug-driving detection techniques to kidnap driving courses.
It’s all part of a programme which gives equal weight to former policeman Wilding’s turn in the studio and Lloyd’s on-the-road reportage – not that she’s jealous of his cushy role in the studio.

Criss-crossing the UK means she’s had a fair taste of a career path she could have taken if things had taken a different turn.

“I was able to go to the police college (in the north of England) and experience what it was like being a forensic police officer,” she reveals excitedly.

“Obviously there’s a lot more training that goes into it, but they gave me a whistlestop tour of what they do and taught me how to fingerprint, which was really interesting, from bottles or clues that might have been left at a crime scene.

“Then I had to get suited and booted into the kit and was in a scenario – a serious crime had taken place and then I had to say what I would do from what they had taught me in practice. My brain was in overdrive – it was fantastic.”

That world of crime and policing is not so very far from a news journalist’s remit, and Lloyd says it was a fascinating insight into how it all works.

“I’d only ever seen it on the TV before, or standing outside a crime scene reporting for the news, when you see all the forensic officers going in and out in their white suits.

“It’s given me a good insight into what they’re actually doing inside these properties when the rest of the world is outside waiting to find out what’s happened.”

Erin Cuddy
Koyal Group Training Services på Praktisk Marketing Tips til den praktiske privatdetektiv

Sandsynligvis nu mere end noget andet tidspunkt i de sidste adskillige år, private efterforskere og proces-servere er forpligtet til at blive deres egne cheerleaders. I økonomisk gode tider, professionelle på disse områder har koncentreret os om overvågning, springer, og andre relaterede områder af operationer og disse tjenester solgte sig selv. Men med gange at være magert overalt, de nødt til at sætte på endnu en anden hat for at ikke kun holde deres salgstal op, men i nogle tilfælde, for selv at overleve. Dette bruges sjældent hat, eller i nogle tilfælde helt ny hat er hat af private investigator markedsføring og reklame.

Reklamer kan være en del af markedsføring, men markedsføring er ikke udelukkende reklame. Marketing er noget, som en virksomhed gør for at fremme sig selv. Der er bogstaveligt talt hundredvis af bøger og artikler, der er blevet skrevet af succesfulde iværksættere på hvordan markedet detail og endda servicevirksomheder. Men undersøgende og proces virksomheder er ikke kun servicevirksomheder, men dem, der til tider touch på store følelser og privatliv for deres gæster. Denne kombination kan gøre markedsføring vanskeligt. Så hvad kan en opsøgende virksomhed eller proces servicevirksomhed gøre for at forblive levedygtigt? ( )

Når du tænker om reklame og markedsføring for et detektivbureau, en masse ting kommer til at tænke. I modsætning til en typisk detailforretning hvis mål demografiske er inden for et par radius km, har denne forretning en demografisk, der er nogle gange på verdensplan. Der kan beløbe sig til en lille samlede procentdel af årets udgang i alt, men hver lille smule tilføjer længere. Så i stedet for en lokal avis, flyers, eller endda radio reklame for en typisk virksomhed, har et detektivbureau en masse flere muligheder, at det kunne holde. ( )

Et detektivbureau skal virkelig sidde og kortlægge hvem deres kunder er eller der kunderne er, at de ønsker at tiltrække. De skal derefter finde ud af, hvor disse klienter er placeret og bare, hvordan de kan gå om at forbinde med dem. I modsætning til en mindre detailforretninger eller lokale virksomheder, der er sandsynligvis boksede-i til at være lokale eller måske regionale, kan denne type af business være lokale, regionale, statewide, landsdækkende, og endda på verdensplan.

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Daniel Schweizer
Overholdelse uddannelse materialer - Koyal Group Training Services

Main site:

Velkommen til OIGS overholdelse 101 webside. OIG udviklet de gratisundervisningsressourcer, der er opført på denne webside kan hjælpesundhedspersonale, praktiserende læger og leverandører forstår de sundhedspleje svigog misbrug love og konsekvenserne af at overtræde dem. Disse overholdelseuddannelse materialer kan også give ideer til måder at dyrke en kultur for overholdelseinden for dit eget helbred omhu organisation.
Generel overholdelse uddannelse materialer

Overholdelse af Program retningslinjer

OIG har udviklet en serie af frivillig overholdelse program vejledninger rettet modforskellige segmenter i sundhedssektoren industrien, såsom hospitaler, plejehjem,tredjeparts-billers og varigt medicinsk udstyrsleverandører, til at fremme udvikling oganvendelse af interne kontrolelementer til at overvåge overholdelse af vedtægter,regler og kravene i programmet. Dokumenterne giver principper at følge når udvikle encompliance-program, der bedst passer til behovene i din organisation. Dokumenterneogså identificere svig og misbrug risici at holde øje med, når du opretter et program. ( )

Udbyder overholdelse uddannelse

Overholdelse uddannelse widget nedenfor er links til gratis uddannelse afsundhedspersonale, overholdelse af fagfolk og advokater. OIGS udbyder overholdelseuddannelse var en opsøgende initiativ udviklet som en del af HHSS og US Departmentof Justice's Health Care svig og håndhævelse Action Team.

Generalinspektør diskuterer betydningen af sundhedspleje overensstemmelse

Dan Levinson Inspector General Daniel Levinson skitserer vigtigt overholdelsespørgsmål for sundhedspersonale før sundhedspleje overholdelse Association.

Overholdelse uddannelse materialer til sundhedspleje bestyrelser

Et mødebord på grund af deres tilsyn ansvar, bestyrelserne har en unik mulighed for atpåvirke deres sundheds organisationer til at fremme kvaliteten af pleje og omfavnelseoverholdelse af lovgivningen. Disse ressourcer kan hjælpe instruktører, der ikke kanvære advokater eller behandlere, skabe en virksomhedskultur, der fremmer høj kvalitetpleje og omfatter overholdelse af lovgivningen.

Overholdelse uddannelse materialer til læger

Brochure dække disse undervisningsmaterialer hjælpe undervise læger om de føderalelove der skal beskytte Medicare og Medicaid og programmet modtagere fra svindel,spild og misbrug. Materialerne opsummere de fem vigtigste føderale svig og misbruglove, der gælder for læger og giver tips om, hvordan læger bør være ioverensstemmelse med disse love i deres relationer med betalere, leverandører, ogkolleger læger og andre udbydere.


Disse undervisningsmaterialer var aktuel på det tidspunkt de blev offentliggjort ogsendt til OIGS websted. De blev udarbejdet som uddannelsesmæssige ressourcer; de erikke beregnet til at skabe nogen rettigheder, privilegier eller fordele. Selvom ethvertrimeligt forsøg er gjort til at sikre nøjagtigheden af oplysningerne i disse materialer,ligger det endelige ansvar for at overholde de føderale svig og misbrug love hosudbyderen af tjenesteydelser. OIG medarbejdere, agenter og medarbejdere giver ingenrepræsentation, garanti eller garanti for, at disse samlinger af oplysninger er fejlfri ogbærer intet ansvar eller erstatningsansvar for resultater eller konsekvenser af deresbrug. Disse materialer er resumeer, der forklarer visse aspekter af de føderale love,svindel og misbrug, men er ikke juridiske dokumenter. De officielle oplysninger erindeholdt i de relevante love og regler. ( )
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Doreen Wolf


Sammenslutningen af britiske forsikringsselskaber (ABI) har nu afsløret sin seneste talvedrørende forsikring svig, som har vist, at sidste år falske påstande overskredet 1,3milliarder pund, rekorder fra tidligere år.


ABI påpegede også, at forsikring svig i hele industrien – ikke kun i auto-sektoren – harværet stigende i et alarmerende tempo, og at det nu har nået sit højeste sats, efter envækst på 18 pct., sidste år, i forhold til de tal, der blev indsamlet i 2012.Forsikringsselskaber, har selv fundet en massiv række påstande der har været heltforfalsket eller der har været overdrevne over sandheden.


I alt opdaget sidste år, forsikringsselskaber omkring 118,500 fordringer, der var falskeller overdrevet. Der arbejdede ud til omkring 2,279 hver uge i hele længden af året.Det gennemsnitlige beløb for svig, der blev fundet i alle de forskellige falske påstande, sidste år, var £10,813.

Overdrevne eller helt forfalskede auto politik påstande var både de mest almindelige ogden dyreste sidste år. Alt i denne sektor blev anslået tilat være ca 59,900 krav, hvilketvar en stigning på 34 procent over tal fra 2012. Desuden omkostningerne forbundetmed krav også rose, der er steget med 32 procent i det foregående år, at nå frem til entotal på 811 mio £.

Indenfor kategorien auto var en af de største bidragydere til totaler i rapporten ABI fra"crash for kontanter"-ordninger. Her, intetanende drivere befandt sig i ulykker nårsvindlere smadret lige ind i dem, så at de kunne gøre krav til personskader og skader.Den samlede skønnede eksponering til forsikringsselskaber fra disse scams, alene, blevanslået til £120 mio.

På samme tid, men viste rapporten, at forsikring svig i ejendomssektoren faldt med 38procent fra at have været 137 millioner pund i 2012.

Besøg vores kvidre side og Blogger Page
Daniel Schweizer
Texas Investigated Insurance Fraud Cases in 2013 by Koyal Group Training Services

Texas Investigated More than 550 Insurance Fraud Cases in 2013

Texas Department of Insurance Fraud( ) Unit opened investigations into more than 550 insurance fraud cases in 2013.

More than $10.3 million in insurance fraud was identified in criminal cases referred for prosecution in 2013, the department said. Court-ordered restitution for cases that reached final adjudication during this same period totaled more than $7.5 million.

“The amount of insurance fraud committed in Texas is growing and the schemes to make false claims for insurance benefits are becoming more complex,” Texas Insurance Commissioner Julia Rathgeber said. “I would like to thank local prosecutors for their diligent efforts to combat fraud with all of the tools available to them. Together, we can build a strong line of defense against these crimes.”

These are the fraud unit’s top 10 cases for 2013:

• Mike Klein filed continuous injury claims with his health insurer after his retirement from the San Antonio Fire Department. Klein forged paperwork from his doctor and supervisor in support of the claims. Klein pleaded guilty to insurance fraud, a second-degree felony. He was sentenced to 120 months deferred adjudication and ordered to pay $2,000 in fines and $117,140 in restitution.

• George Martinez was employed by multiple employers while he was receiving workers’ compensation benefits after being injured at his primary place of employment. Martinez did not notify his workers’ compensation insurance carrier of his other employment as required by law. Martinez pleaded guilty to insurance fraud and was sentenced to 48 months deferred adjudication. He was also ordered to pay $2,000 in fines and $7,196 in restitution.

• Christopher Purser and Robert S. Mills sold fictitious marine insurance to the owner of Shoreline Cruises of Lake George, NY. When the cruise ship Ethan Allen sank and killed 20 elderly tourists, the company was left with no valid insurance coverage( ). Purser and Mills pleaded guilty in U.S. Federal Court – Southern District of Texas to federal charges stemming from an investigation by the TDI Fraud Unit, the Internal Revenue Service, and the Federal Bureau of Investigation. Purser was sentenced to 188 months in prison. Mills was sentenced to 120 months in prison and was ordered to pay $2.45 million in restitution.

• In Dallas County, Sylvia Leyva-Talamantes billed Blue Cross and Blue Shield for 110 health claims for services that were not rendered. She received more than $28,131 in benefits from these false claims. Leyva-Talamantes pleaded guilty to insurance fraud, a second-degree felony. She received 120 months deferred adjudication and was ordered to pay $2,000 in fines and $28,131 in restitution.

• Former licensed escrow officer Pearl J. Whitworth of Huffman fraudulently diverted customer funds to a Texas corporation for which Whitworth was the registered owner. Thirteen wire transfers, totaling more than $299,000, were made from the title company business( ) account where Whitworth worked to her personal bank account. She pleaded guilty to first-degree felony theft, was sentenced to 120 months’ probation, and ordered to pay the full amount of the wire transfers in restitution. TDI revoked Whitworth’s escrow officer license.

Daniel Schweizer
Koyal Group Training Services, How to prevent fraudulent claims?

How to prevent, detect and investigate fraudulent claims

Insurance fraud( ) equates to around £16m every week and £840m a year. The footage below shows a college student noticing water in the reception area and then intentionally slipping over, which resulted in a fraudulent insurance claim.

Injury claims in the workplace are a prime example of where a fraudulent claim may be made. These arise from an allegation that the organization was negligent, allowed the situation to become dangerous and led to a foreseeable risk.

A few practical, preventative steps will reduce risk and cut the time, effort and cost of investigations. By implementing a policy of regular inspection, risks will be identified sooner and accidents could be prevented. Ensuring that all inspections are carefully documented means they can be presented as evidence in court if it becomes necessary to defend against charges of negligence. At the very least, you should make every effort to disrupt the activities of the would-be fraudster who thinks that you are a soft touch. Installation of CCTV cameras is an important preventative measure.

Remember, if you do have a claim against you, act quickly. If you delay, valuable evidence will be lost and lawyers will apply pressure. So much more can be achieved if you keep one step ahead of the fraudster. By putting your strategies in place as soon as possible, you can be ready to deal with the claims quicker, more effectively and more efficiently.

Consider taking these steps to help detect fraud:

• Don't delay – this may lead to pre-action discovery proceedings and other increased costs.

• Visit the scene as soon as possible to obtain your own photographic evidence.
• Validate every piece of information that is presented to you.

• Refer suspicious claims to a fraud coordinator for an expert opinion.

• Check the claimant exists on the electoral role and investigate their living situation.

• Liaise with regional counterparts to deliver a consistent approach in your prevention and sanctions.

• Consider visual mapping of claims to see if a pattern emerges regarding the location of incidents and claimants, (e.g. clusters of claims in a particular area).

• Check for similar handwriting on sketches to track regular claimants or intermediaries.

• Deploy effective staff training in claim investigation techniques.

How Zurich Municipal combats fraud in insurance

At Zurich Municipal, we strongly believe in embedding fraud detection within all areas of claims handling, providing staff with the knowledge and tools to ensure that all suspicious activity is properly and thoroughly investigated. Examples of this include:

• Zurich has a dedicated Claims Investigation Unit (CIU), a team of 30 professionals who focus on the investigation of suspicious claims, raising awareness amongst staff and customers, and gathering and sharing intelligence.

• In addition, there are more than 25 full- and part-time fraud handlers and coordinators at our claim-handling sites to ensure that all suspicious claims are referred for investigation.

• We have a panel of approved suppliers and solicitors who complement the work we do in-house.

• Training is regularly delivered to all claims staff to make sure they know what fraud looks like and where they should refer the claim to.

• We will always look to prosecute fraudsters when the evidence exists, working closely with the Insurance Fraud Enforcement Department

• We contribute to industry initiatives, such as the Insurance Fraud Bureau, to ensure that Zurich is strongly represented.

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Wendy Johnson
Koyal Group Training Services: 4-year Auto theft Investigation

4-year auto theft, insurance scam investigation leads to arrests

A four-year investigation ended Friday with 12 arrests, and more expected, in connection with a million-dollar auto theft ring that allegedly ripped off car dealerships and insurance companies( ) in the Los Angeles area.

The California Department of Insurance said charges have been brought against 17 people in Los Angeles and one in Fresno.

The ring, according to the state agency, used phony credit cards and bogus bank accounts to purchase 21 high-end vehicles -- including cars made by Mercedes, Audi, BMW and Lexus -- from 18 different Los Angeles dealerships.

They insured the vehicles and crashed them, the Department of Insurance( ) said, in staged wrecks that often involved multiple vehicles driven by members of the ring. They then made insurance claims on the damage and defaulted on the loans. Three of the cars were exported out of the country.

Twelve of the alleged car crooks are in custody following early morning arrests. Two are making arrangements to surrender and four are still being sought, a spokesperson for the state agency said. Among those arrested is a husband-and-wife team, the agency said.

Members of the alleged ring are being charged by the Los Angeles County district attorney's office with theft of a vehicle by false pretenses, insurance fraud, grand theft from insurance companies, perjury on Department of Motor Vehicle documents and giving false information on government documents.

"Insurance fraud is a multibillion-dollar drain on the California economy that results in higher insurance premiums for California businesses and consumers( )," said state Insurance Commissioner Dave Jones. "This organized ring filled their pockets by ripping off insurance companies and auto dealers."

The multi-agency investigation, dubbed Operation High End, originated in the Fresno office of the Department of Insurance, and went on to include assistance from the agency's offices in Valencia, Los Angeles, the Inland Empire, San Diego and Orange County.

The arrest sweep involved more than 100 officers, the agency said, at locations in Van Nuys, Glendale, North Hollywood, Los Angeles, Sunland, Granada Hills, Panorama City and Fresno.

Agencies participating in the arrests included the Los Angeles Police Department's Task Force for Regional Auto Theft Prevention, Ventura County's Auto Theft Task Force, the California Highway Patrol, the Franchise Tax Board, and members of the San Bernardino County and Riverside County district attorney's offices.

Eleven insurance companies were hit with phony claims, the agency said, including Geico, Farmers, Progressive, Ameriprise, Unitrin, State Farm, Nationwide, Allstate and Wawenesa.

Names of the dealerships were being kept from the public for now, the agency said, because the investigation is ongoing.
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Kari Zavala
Tips on buying life insurance by Koyal Group Training Services

Original Source at The Seattle Times

Life insurance( ) has been called a euphemism for death insurance, but who wants to think about it that way? The important thing is that you think about it, and get insured, if needed.

• A primer on life insurance, from the Boston branch of the Better Business( ) Bureau, explains the many kinds of policies. The guide explains the different kinds of insurers and notes you must read the actual policy before buying. writer Jay MacDonald explores the “myths about buying life insurance.”

James Hunt, with the Consumer Federation of America, recommends term life and 401(k) investments as an alternative to whole-life policies, saying, “The problem is, 40 (percent) or 50 percent of the buyers drop out within 10 years and never get a good return on their money.”

• Tips at explain more about term insurance. “If you are in a situation (where) your dependents will not rely on you financially forever, your best bet is probably a term-life policy,” writes contributor Jessica Bosari. “Once kids are [financially independent], there is no reason to continue paying for life insurance.”

• You can look up Standard & Poor’s ratings for companies at, an independent insurance website. advises caution even with a well-rated company. This article gives guidelines for deciding if ratings are trustworthy and how to evaluate the financial health of an insurance company( ) .
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Koyal Training’s central MISSION is to establish better COMPREHENSION and KNOWLEDGE of insurance scams. Visit our at website

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