ANNUAL REPORT

2019

The NICB has never shied away from a good fight, especially when it comes to criminals who steal from our members and the American public. In 2019, we focused on bringing tools to our members’ fingertips in the form of interactive dashboards. These dashboards allow members to detect trends in their own data and identify fraudsters for further investigation based on their companies’ specific priorities.
 
The first is the NICB Member Questionable Claim (QC) Dashboard which supports analyses of aggregate questionable claims information submitted by member companies. Accessible via ISO ClaimSearch^®, this dashboard visually presents QC data for the user’s group of companies using tables and maps, allows for instant filtering on multiple categories, and supports data downloading for further trend analysis, including referral reasons.
 
The QCNET℠ Dashboard provides member companies with the ability to quickly identify specific parties for investigation. These involved parties are all designated as a subject of investigation within two years and appear in at least two QCs during the previous five years. This tool allows users to focus research on loss details, subject details, or even individual identifiers of all NICB Questionable Claims. Developing strategic leads has never been easier.

Another 2019 priority was to focus on collecting pharmaceutical data to identify fraudsters involved in drug prescriber and dispenser abuses that have decimated families and communities nationwide.  

 
For years, we’ve mined the NICB Aggregated Medical Database (AMD) to research, analyze, and investigate fraud patterns and trends in medical billing. We have used this data to identify and report on medical providers potentially engaged in unscrupulous practices. In 2019, we expanded the AMD and began to collect prescription data related to automobile and workers’ compensation claims. The goal is to uncover providers and pharmacies possibly committing insurance fraud, especially related to opioid-based painkiller medicines.
 
With assistance from nursing and pharmacy experts at Verisk, our Data Analytics team has developed essential data elements to begin mining aggregated prescription data to identify fraud trends; establish baseline behavior to detect provider and drug outliers; publish alerts on potential fraudsters; and support NICB medical fraud investigations.

With highly trained, well-equipped field agents and staff in eight regional and foreign operations offices, as well as eight task forces nationwide, the NICB operations team continued to develop medical, commercial, and vehicle fraud cases in 2019 that captured the attention of law enforcement agencies and prosecutors.

Today’s automotive industry is synonymous with technology, with vehicles containing anywhere from 30 to 100 microprocessors running up to 100 million lines of computer code and controlling such functions as the engine, fuel, braking, air conditioning and heating, cruise control, and entertainment systems. These microprocessors constantly collect data, which if harnessed, can yield tremendous information about the vehicle’s history, as well as the driver and other occupants.

Recognizing this data’s potential, the NICB is working to leverage that technology to assist with vehicle crime investigations. By investing in new technologies during 2019 capable of downloading vehicle infotainment data, we are now poised to offer members the ability to investigate vehicle fraud crime and uncover previously unavailable evidence.

The Geospatial Intelligence Center program (GIC) continued its remarkable growth with more NICB members joining this innovative fraud solution that uses high-resolution aerial photography to enhance fraud prevention efforts, claims management, and payment processes following disasters.
 
While the United States was thankfully not hit as hard in 2019 with storms and other catastrophes, the GIC provided real-time property damage imagery from several California wildfires, as well as tornadoes that ripped through Dallas. GIC aircraft canvassed the affected areas to capture and assess damages so that members could more quickly support their policyholders during their time of need.

GIC images also offer valuable evidence for NICB fraud investigations and in preparing cases for prosecution.

For example, we used GIC data in an investigation which supported a 35-count federal indictment against two former City of Lynn Haven, Fla., officials and several local business people for allegedly conspiring to process approximately $5 million in fraudulent storm clean-up invoices from 2018’s Category 5 Hurricane Michael.

Flying the anti-fraud flag in 50 state legislatures and on Capitol Hill requires a team effort. While the NICB Government Affairs Department totals just four professionals, our ambition and vision are expansive. One of our secret weapons is leveraging the sheer number of members and partners who share our commitment to supporting strong anti-fraud laws.

This was perhaps best exemplified by our collaborative effort with industry partners in New York to pass a vital insurance fraud-fighting tool that provides civil immunity protections for information sharing.
 
In 2019, our Government Affairs team also engaged with members and state insurance trade associations in Michigan, Nevada, and Texas to pass legislation for additional resources and funding for state fraud bureaus; we promoted legislation in Indiana to curb tow truck abuses; we provided vital testimony to support a new law in Kentucky to curb solicitation of accident victims; we lead the effort to allow California rental vehicle companies to report stolen and fraudulently obtained vehicles more quickly; we strongly supported a successful effort in Oregon to modify state statutes so prosecutors can secure convictions against car thieves; and we supported successful reforms in Florida and other states to curb frivolous litigation and assignment of benefits abuses.

We also visited Capitol Hill to promote the NICB’s important role in sharing vehicle theft and export information with U.S. Customs and Border Protection agents; hosted the National Conference of State Legislatures’ Insurance Task Force; executed a Pennsylvania towing forum that attracted 100-plus attendees; and held our second annual Dedicated Insurance Fraud Prosecutors Conference, which saw a 30% attendance increase.

The legion of companies joining our collective efforts to stop insurance crime continued its consistent growth rate in 2019. With our membership roots in the property-casualty insurance industry, today they’ve branched out to rental car companies; the food and beverage sector; web-based financial services firms; tractor-trailer leasing companies; and many other enterprises.

Regardless of their line of business, every active and associate member and strategic partner expects the same thing from NICB membership: Value and dedication to the mission of combating insurance fraud and theft.

And in 2019, our Membership team made a concerted effort to demonstrate that value to enhance membership retention and satisfaction. We do that by first closely listening to, and properly ascertaining, our members’ needs. From there, we create programs and services that support their fraud-fighting efforts. We next encourage them to fully utilize NICB solutions and realize the resulting benefits.

And to close the loop, we report operational results through a variety of approaches, including our membership management dashboard, Learning and Development forums, and personal visits by membership directors.

The NICB has welcomed more than 40 new members and strategic partners during the past three years. Our focus is on “growing responsibly,” as we expand at a rate equal to our resources and ability to provide effective services to members.