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ABOUT OUR WORKSHOP SPEAKERS 2007
(Speakers are listed in alphabetical order
by last name).
Helen Alford, Alford, Clausen & McDonald,
LLC 3.9, 6.9
Helen Johnson Alford is a partner with the law firm of
Alford, Clausen & McDonald, LLC. She obtained her law
degree from Tulane University in 1982. She is a member of
the Alabama Bar, Mississippi Bar, Tennessee Bar and Texas
Bar. She is Secretary/Treasurer of the Alabama Defense Lawyers
Association and a member of the Mississippi Defense Lawyers
Association, DRI, and Federation of Defense & Corporate
Counsel.
John K. Allen, Ed.D., Partner, West Falmouth Associates
LLC 1.8
John is an organizational psychologist and executive coach
specializing in the people side of management effectiveness.
His national consulting practice focuses on employee selection
and organization development. In adddition to his 25 years
of consulting experience, John provides an operating manager’s
perspective gained from his experience as CEO of a national
wholesale company and group executive of an international
maunfacturer. He is President of the new England Society for
Applied Psychology.
Joel Amar, Blue Cross and Blue Shield of Florida 4.7
Mr. Amar started working as a Personal Service Representative
in Membership and Billing and held that position until 2002.
In 2002, he was promoted into a Service Manager role for First
Coast Service Options Inc., the Medicare Subsidiary of BCBSFL.
In early 2004, he transferred into Blue Cross Operations.
Since joining Blue Cross, he has become a certified Facilitator
and Trainer for Rapid Process Improvement, he is certified
in Process Management, and he is certified as a Define, Measure,
Analyze, Improve, Control Green Belt. He is currently focused
on Claims Accuracy and Continuous Improvement initiatives
across BCBSF, utilizing Six Sigma methodologies.
Patricia Bailer, JHA 7.3
Pat is Director of Claims & Account Management, Individual
Disability Reinsurance. She is responsible for managing the
account relationship with JHA’s Individual Disability
reinsurance clients. In this role, she utilizes her significant
industry experience to help clients manage risk and improve
business performance. Pat also writes about individual disability
topics of interest in industry publications and is often a
requested speaker at industry meetings. Prior to joining JHA,
Pat was Director of the Psychiatric Impairment Unit at Unum.
Over a 20 year career at Unum, Pat held various management
positions in the disability business, in areas such as complex
claim management, sales & marketing, and customer service.
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Michael F. Bell, Galton & Helm LLP 1.11, 5.12
Mike has been admitted and practicing law in California
state and federal courts since 1979. His practice has focused
on the representation of life, accident, health, and disability
insurers in coverage, bad faith, and ERISA litigation. He
also represents insurers and financial service companies in
NASD arbitration proceedings and related financial services
litigation. Mike is a 1976 graduate of Texas Christian University
and he obtained his law degree from Stanford Law School in
1979. He is a member of the International Claim Association,
the Association of Southern California Defense Counsel, the
Defense Research Institute, and the Los Angeles County Bar
Association. Over the past five years, Mike has been a frequent
speaker and panelist at industry meetings and conferences,
including ECC, WCC, and ICA Annual Meeting.
Gary Blake, Ph.D., The Communication Workshop 1.10, 4.10
Dr. Blake is director of The Communication Workshop and has
presented writing seminars at more than 200 companies throughout
the United States, United Kingdom, and Bermuda. He has presented
hundreds of on-site writing seminars for claims, underwriting
and risk management professionals and has written for most
of the field's leading trade magazines, including Best's,
Claims, Insurance Advocate, and National Underwriter. He has
presented programs at many leading claims conferences, including
past International Claims Association. Dr. Blake holes undergraduate
and master's degrees from the University of Wisconsin and
a Ph.D. from City University of New York.
Alvin Bowser Ecom PPO Advisors 1.6
Alvin has more than 15 years combined experience in the healthcare
and PPO industries. He has worked at every level within the
payer community, and understands all of the inner-workings
of a claims environment. He spent the first nine years with
a very successful health insurance carrier serving in several
capacities during his tenure which include; mailroom, customer
service, claims and PPO administration. He witnessed first-hand
the benefits of outsourcing PPO administration at the health
insurance company, as the PPO network managed care savings
doubled in one year. Wanting to bring these claim savings
and operational efficiencies to other companies in the industry,
he joined the Ecom team in 2001. As Vice President of Operations
he is responsible for overseeing all facets of Account Management,
Claims Operations and PPO/Vendor Management.
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Ruth Brayer, Brayer Handwriting International 2.9
Ruth Brayer is a forensic document examiner, qualified as
an expert witness by the Supreme Court of the State of New
York and author of Detecting Forgery in Fraud Investigations.
Brayer is a seasoned presenter with over twenty years of experience
in the field of Forensic Document Examination. Brayer is the
owner of Brayer Handwriting International, a New York City
consulting firm, specializing in handwriting and signature
authentication. She has provided expert testimony to the National
Association of Securities Dealers, the U.S. Securities and
the Exchange Commission, the Department of Investigation of
the City of New York, the New York City Law Department and
the Office of the District Attorney. Brayer has provided services
to Fortune 500 companies, government, financial institutions
and major law firms.Ms. Brayer is the author of Detecting
Forgery in Fraud Investigations: the Insider’s Guide,
published by the American Society of Industrial Security (ASIS).
She is also the author of an article entitled “When
Evidence is on the Line,” published in Security Management
magazine. Ms. Brayer is former president of the National Speakers
Association New York Chapter, and currently a member of the
National Association of Document Examiners.
Laura Burklin, MBA, FLHC, AIRC, AAPA, Allstate Life Insurance
Company 6.2
Laura has over 22 years of insurance operations experience
with Allstate Life Insurance Company in annuity and life claims.
She is currently the Annuity Claim Division Manager directing
people, process and projects. Laura recently obtained her
Master of Business Administration degree from the Lake Forest
Graduate School of Management.
Marc A. Cohen, Ph.D., LifePlans, Inc. 4.6
Marc is the President of LifePlans, Inc., a long-term care
insurance services, risk management and research company.
LifePlans works with insurers to enhance their capacity to
better manage the risks associated with long-term care. They
also work with Foundations and trade associations on issues
related to private and public initiatives in long-term care
financing for the elderly and disabled. Dr. Cohen has published
widely on topics related to long-term care insurance, risk
management, services utilization, and the interactions between
the public and private market as well as on public policies
affecting the elderly. Dr. Cohen received his Ph.D. from the
Heller School at Brandeis University and his Masters Degree
from the Kennedy School of Government at Harvard University.
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L. David Covino, CLE, ALHC, Unum Group 2.5, 5.4
David Covino is currently the SIU Manager for Unum where he
has been employed for the past 17 years. He was previously
employed by First Security Services Corporation as Investigative
Group Manager. He was appointed both a Deputy Sheriff in Lafayette
Parrish, Louisiana, and a Special Officer in Cumberland RI.
Mr. Covino is a former president of the New England Anti~Fraud
Association. He was formerly the Executive vice-president
of the New England Chapter of the Association of Certified
Fraud Examiners and is the former Director of Training. He
has been a member of the organization for 12 years. Additionally,
Mr. Covino is the former 3 term Program Chairman- for the
New England Claim Association, is currently a member of the
Executive Committee, and has been in his present position
for 3 terms. Mr. Covino is also a member in good standing
of the International Association of Law Enforcement Intelligence
Analysts; American Society for Industrial Security; Association
of Investigative Managers; Association of Certified Fraud
Examiners; High Technology Crime Investigator's Association,
International Association of Special Investigative Units;
Narcotics Enforcement Officer’s Association, and is
a frequent speaker on Disability Insurance Fraud.
Steven P. Del Mauro, McElroy, Deutsch, Mulvaney and Carpenter,
LLP 2.10, 7.2
Steven is a partner with McElroy, Deutsch, Mulvaney and Carpenter,
LLP in Morristown, New Jersey. He has extensive experience
with respect to claims for benefits under individual and group
policies of insurance, class action litigation, market conduct
practices litigation, insurance fraud and agent/broker liability.
He received his undergraduate degree from Seton Hall University
and his law degree from Seton Hall University School of Law.
Jeffrey Denault, ALHC, Unum Group 2.5, 5.4
Jeffrey Denault is currently an Assistant Vice President for
Unum. He has over 20 years of Disability Insurance experience.
He has been with UNUM for 12 years. He oversees the Complex
Claims Unit, the Mid Atlantic Region and the Alternative Resolution
Team within the Individual Disability Claims Operation in
Worcester, MA. He is a former officer of the New England Claim
Association and currently, is a member of the Executive Committee.
Jeff received his undergraduate degree from the University
of Massachusetts in Amherst, MA.
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Robert S. Dubiel, ALHC, Unum Group 1.5, 2.4, 3.4
Bob has 40 years of Group, Association and Individual DI claims
experience with the Hartford Life Insurance Companies and
Unum. He currently serves as the Director in the Individual
DI Claims Department at Unum. Bob received his undergraduate
degree from LeMoyne College in Syracuse, New York.
Alan Ehrlich, M.D., Trustmark Insurance Company 4.4
Dr. Alan Ehrlich is the Medical Director for Disability Benefits
at Trustmark Insurance Company. He attended the Robert Wood
Johnson Medical School and completed a residency in Family
Practice at the University of Massachusetts Medical Center.
He joined Trustmark in 2002 after 15 years in clinical practice.
Prior to joining Trustmark he was the Chairman of the Family
Practice department at the Fallon Clinic a large multi specialty
group practice in Worcester, Massachusetts. In his role as
the Medical Director for Disability at Trustmark, Dr Ehrlich
is involved with numerous insurance products related to disability
including Individual DI, Group LTD, STD, Life Waiver, Critical
Illness and Long Term Care. Dr. Ehrlich’s previous presentations
at medical and insurance industry conferences on disability
topics have been well received.
Sally-Anne Etienne, Swiss Re 6.3
Sally-Anne is currently the Director and Head of Life & Health Claims for the UK, Ireland & South Africa for Swiss Re based in London. During her 26 year career in the industry, 10 years of which working with Swiss Re, she has also worked in direct offices in the new business, operational and claims arenas covering all aspects of disability insurance, critical illness, TPD, death, terminal illness and long term care. Sally-Anne is actively involved in the UK industry to help educate analysts and raise standards through her work with the Association of British Insurers TCF Health Claims Protection committee and UK Health Claims Forum as Secretary & Treasurer
A. Kenneth Fine, Western Reserve Life Assurance Company
of Ohio 3.8, 6.10
Ken is presently Vice President, Senior Counsel and Market
Conduct Compliance Officer/Anti-Money Laundering Compliance
Officer for Western Reserve Life Assurance Co. of Ohio, a
member of the AEGON Group. He has over 35 years of life insurance
company experience, to include prior stints with Guardian
Life and USLIFE Corporation, where he served as Associate
Counsel. He is a C.L.U. and has completed his Associate designations
in Customer Service, Claims and Regulatory Compliance with
the Life Office Management Association. Ken is a Certified
Anti-Money Laundering Specialist with the Association of Certified
Anti-Money Laundering Specialists. He also holds licenses
6, 26 and 63 with the NASD. He is a member of the New York
Bar and certified as Authorized House Counsel with the Florida
Bar.
Nancy Ford, Principal Life Insurance Company
5.10, 7.7
Nancy has a BA in business administration and holds the designations
Fellow, Life Management Institute; Associate, Customer Service;
and Associate, Life and Health Claims. She has over 30 years
experience handling claims, compliance and management duties
for Principal Life Insurance Company. Her background includes
work with group life and health products. For the past 5 years,
Nancy has worked with Individual Life Claims.
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Harriett B. Frizie, ALHC, Munich American Reinsurance
4.5
Harriet Frizie is a Claims Coordinator at Munich American
Reassurance Company where she oversees the claim adjudication
process of reinsured Individual Disability Income claims.
She has been with Munich since April, 1999 and has over 25
years experience in the Group Long Term and Individual Disability
Claim Industry.
Louie Gravance, Louie Gravance Creative Concepts, General
Session, 1.12
Louie Gravance, a native Californian, is literally changing
the consciousness of business in America through his speaking
and consulting skills. Gravance was a perfect fit for this
project, thanks to skills learned and honed during a twelve-year
tenure at The Walt Disney Company in Orlando, Florida. Beginning
with the training and orientation program “Traditions”
at The Disney University, Louie designed, developed, and delivered
countless presentations. First, at the University for literally
thousands of Disney World employees from all disciplines,
and then for visiting corporate clients through the Disney
Institute Professional Development Programs. A premiere example
is the work he has done is helping Bank of America navigate
what he calls a “culture shift.” Money Magazine
credits these efforts with “making the banking experience
more pleasurable with changes that have improved customer
satisfaction.” This was done through an initiative Gravance
introduced to high level executives and employees entitled
“The Bank of America Spirit.”
Mr. Gravance has also traveled North America, teaching “Showmanship
in the Workplace” to large companies like ING Financial,
Mutual of Omaha, Fisher Scientific, Toys 'R Us and BMW of
Canada, just to name a few. Prior to moving to Florida, Mr.
Gravance began a show business career at the age of twelve.
He spent the next two decades in Los Angeles appearing in
stage shows, sitcoms, motion pictures and over 35 national
television commercials. While at Disney, he led, trained,
and performed with the improvisational comedy show “Streetmosphere”
at the Disney / MGM Studios from the first year of its inception
in 1989. Currently, Louie Gravance Creative Concepts is located
in Palm Desert, California.
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Fred W. Gossman, III, CPA 4.5
Fred Gosman has been a leader in providing forensic and investigative
accounting services for the insurance industry since 1989.
He has been involved with thousands of claims, including claims
for disability income benefits arising from total or residual
disability. He has also analyzed business overhead expense
claims, performed valuations for buy-sell coverage, as well
as analyzed the claimed activities or duties of many professionals.
He has provided expert testimony and exhibits in state and
federal courts across the United States. He has made presentations
at various claims seminars, including the Eastern Claims Conference,
Western Claims Conference and Southern Claims Conference.
Gregg Grunewald, ALHC, UnitedHealth Group 7.5
Gregg is a health claim professional at UnitedHealth Group
with over 12 years experience in management in the health
claim industry. His focus has been centered around all aspects
of health claims operations including quality improvement
and control. Gregg earned his Bachelor of Arts, Summa Cum
Laude from Lakeland College and is completing his Masters
Degree in Business Administration.
Dale E. Harn, VP of Business Development, HOV Services
3.7, 5.9
Dale has 18 years experience in the BPO industry including
AMR Information Systems, National Processing Company and Image
Process Design. He has expertise in offshore, nearshore and
domestic healthcare payer focus involving mailroom, image,
capture adjudication, print and member support contact centers.
Dale has worked with several major insurance carriers including
United Health Care, CIGNA, Aetna, and Multiple Blues Plans.
Kate Harri, MA, Behaviorial Medical Interventions
6.4
Ms. Harri is a Licensed Psychologist, at Behavioral Medical
Interventions. BMI specializes in Disability Management, Workplace
Violence Risk Management, Threat Assessment, Fitness for Duty
Examinations and Vocational Assessment and Management Coaching.
She has over 25 years experience in the mental health field
in a variety of settings. She has authored several articles
on mental health concerns in the business environment and
recently been published in the Hennepin Lawyer, Employee Benefits
Planner, HRP Newsletter and Disability Forum. Her most recent
article focused on Bipolar Disorder.
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Robin Ayers Healy, ALHC, FLMI, Unum Group 3.4
Robin has over 14 years of individual disability claim experience with Unum. She is currently Assistant Vice President in Worcester Benefit Operations responsible for Southeast region. Robin received her undergraduate degree from Assumption College in Worcester, MA.
Dan Hepner, Union Central Life Insurance Company 2.9
Dan’s resume includes the investigation of individual
disability, individual life claims as well as SIU assignments
since 1985. Prior to his insurance investigative career, he
was in law enforcement with a major metropolitan police department.
Dan has a Bachelor/Science Degree Criminal Justice/Behavioral
Sciences and has been a speaker at ECC, ICA and NHCAA conferences
over the past 10 years.
Jack J. Johnsey, The Jacobson Group 4.8
Jack J. Johnsey is a Senior Vice President of The Jacobson
Group and plays a significant role in the continued development
of the niche professional and human capital services firm.
In addition, Johnsey leads the firm’s Jacobson Solutions
– Project Solutions division, which is the premier provider
of travel-based interim project teams in rapid response to
the insurance/managed care industry’s critical and often
unforeseen workload situations. Johnsey is also a key member
of the firm’s Executive Advisory Board.
Johnsey brings 20 years of business development expertise
to his executive role with Jacobson. His dynamic background
encompasses a proven track record of strategy-building, operations,
marketing and human resources in the healthcare, customer
service and consulting arenas. Most recently, Johnsey served
as the Senior Vice President of Sales for SHPS, Inc. His successful
career also encompasses leadership tenures at APAC Customer
Services, Inc., and Hyperion Solutions Corporation. Johnsey
is an active participant in the insurance/managed care community
and participates in a number of industry events on both the
local and national levels. He is also a member of the Executive
Club of Chicago. His industry perspective is also highly valued
and he is often called upon to share his insights on topics
such as claims process improvement and support strategies.
Johnsey is a firm believer in giving back to the community
and, as such, volunteers his time with various community initiatives,
including the Crystal Lake Service League Philanthropy Committee,
the YMCA Indian Princess program, and a number of local youth
sports teams. Johnsey graduated with a Bachelor of Arts degree
from Miami University of Oxford, Ohio.
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Elaine Johnson, Blue Cross and Blue Shield of Florida
5.7
Elaine joined Blue Cross and Blue Shield of Florida in 2003
and currently serves as Director of Human Resources and Business
Integration for the Service and Public Affairs organizations.
She earned an MBA from the University of North Florida, and
is a cum laude graduate of the University of South Florida
with a BS in Management. She received her national accreditation
as a Senior Professional in Human Resources and served as
an instructor in the Human Resource Certification Program.
Elaine’s community involvement includes serving as a
member of the Business Advisory Council for the Coggin College
of Business at the University of North Florida, member of
the Executive Committee for the First Coast Workforce Development
Board, serves on the Florida Community College of Jacksonville’s
Business Programs Advisory Committee and functions as standing
facilitator for the First Coast Nurse Leader Consortium and
the Ronald McDonald House Board of Directors.
Neal Jones, General Re 2.3, 3.1, 5.2
Neal has been involved with the insurance industry since 1970.
The last 10 years with reinsurance, currently General Re.
Neal is one of two surviving founders of the Eastern Claim
Conference and a past Conference Chairperson. Neal's claim
experience has encompassed all aspects of both Group and Individual
products. Neal is always ready to share his experiences and
knowledge with all he comes into contact with.
Judi Kimmell, RN, C.P.N., M.A., EBMS, Inc.
3.6, 6.6, 7.6
Ms Kimmell has over 15 years of experience in the health care
environment. She has an undergraduate degree in Nursing and
a Master’s degree in Organizational Management. Past
public speaking opportunities have surrounded claims operation
efficiencies, staff development and coaching, industry trends,
as well as quality in the payer environment. Ms. Kimmell has
been at Employee Benefit Management Services, Inc, a Third
Party Benefit Administration company located in Billings Montana.
She also is an active member on the Executive Committee for
the International Claims Association. EBMS currently is a
member of SIIA, SPBA, ICA, HCAA, and other industry appropriate
associations.
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Larry B. Lambert, Center for Asian Crime Studies 1.1,
4.1
Larry B. Lambert consults with Fortune 500 companies and others
on matters of corporate intelligence and crisis management.
He is retired from the Orange County (CA) District Attorney's
Office where he worked extensively in the field of Asian Organized
Crime investigation and prosecution and from commissioned
service with the US Navy's special operations and intelligence
communities. His background as a senior manager in national
security, international diplomacy and multi-national projects
extends through Europe, the Middle East and Asia. Mr. Lambert
has lectured and conducted specialized training on topics
related to Asian Organized Crime in Asia, the Asian Subcontinent,
Europe and North America. He is a past president of the International
Association of Asian Crime Investigators and currently serves
as deputy director of the Center for Asian Crime Studies,
a Maryland-based think tank focused on criminality by ethnic
Asians.
James Lampkin, Alford, Clausen & McDonald, LLC 2.11
James is an equity member of Alford, Clausen & McDonald,
LLC concentrating his practice in the defense of insurance
companies. James is admitted to the State Bars in AL, MS,
FL and GA, including all federal courts in AL and MS and the
Northern District of Florida. He is also admitted to practice
before the US Supreme Court, the Fifth Circuit Court of Appeals
and the Eleventh Circuit Court of Appeals. He is the Editor
of the Alabama Defense Lawyers Journal and a member of the
Alabama Defense Lawyers Association, the Alabama Trial Lawyers
Association, DRI, International Association of Defense Counsel
and the International Claims Association. He has spoken at
the EEC and several NBI seminars involving insurance matters.
He is a member of the Insurance Committee and the Life, Health
& Disability Committee of DRI. He has published numerous
articles regarding insurance clams litigation. He is a 1989
cum laude graduate of Cumberland School of Law and obtained
a BS Degree from East Tennessee State University.
Lisa Lechowicz, 3.5
Lisa is the CEO and founder of HDM Corp. (HDM). HDM Corp. was established to find a better way to administer health care. In establishing HDM, Lisa also had a dream of a new way to do business with a culture that creates a win-win-win for the customer, the employee and the firm. HDM also takes corporate responsibility seriously and is dedicated to giving up to 10% of profit back to the Community. Before establishing HDM, Lisa served as Senior Vice President of Health Care Business Operations for Mutual of Omaha. She was responsible for the following areas: claims processing, customer service, as well as other administrative functions for both Group and Individual products. Lisa initiated health care system initiatives and created Mutual of Omaha’s EDI vision. She served on the Board of the Work Group for Electronic Data Interchange (WEDI). Lisa has an extensive background in systems development, project and process management, consulting, planning, and claims management within the health insurance industry. Prior to joining Mutual of Omaha, she consulted on projects and systems with companies nationwide. Lisa has both a Bachelor’s and Master’s degrees in Management from Purdue University. She also holds various professional designations including CLU, ChFC, FLMI, CEBS, HIA, and ACS.
Dan Leeper, 1.7, 5.6
Dan Leeper is currently assigned as a Supervisory Special Agent in the Cleveland Division of the FBI. He joined the FBI in 1999 and was assigned to the Los Angeles Field Office upon graduation from New Agents Training. His investigative experience includes many significant health care fraud cases, including large scale undercover matters and multi-agency initiatives. In 2005, Mr. Leeper was promoted to the Health Care Fraud Unit at FBI Headquarters where he had health care fraud program responsibility for FBI field offices in the Central Region of the United States. He also served as the Health Care Fraud Unit's coordinator for HIPAA Medical Privacy matters and was the FBI liaison to several organizations and agencies, including the U.S. Department of Health and Human Services, National Insurance Crime Bureau, and AARP. In 2007, he was assigned to the Cleveland Division and currently supervises FBI health care fraud investigations in Northern Ohio. Mr. Leeper received undergraduate and law degrees from Capital University in Columbus, Ohio and earned a Masters of Law (LL.M.) degree from the University of Florida Law School. Prior to joining the FBI, Mr. Leeper practiced law with the law firm of Bricker & Eckler LLP in Columbus, Ohio. He was a member of the firm's Tax Law Department and represented hospitals, health care systems, and other health care providers in areas including exempt organization matters, transactional issues, and regulatory law.
Robert P. Lesko, McCarter & English,
LLP 1.11, 5.12
Rob represents insurance companies and other financial institutions
in civil and complex commercial litigation before courts and
arbitration panels in New Jersey, New York and Pennsylvania.
His experience includes litigation of claims for benefits
under individual and group life health and disability plans
and policies as well as claims relating to the sale of such
plans and policies. Rob graduated from Pepperdine Unversity
School of Law in 1993, and has practiced in the area of life,
health and disability insurance ever since. He is a member
of the ICA Law Committee, the Defense Research Institute Life
Health and Disability Insurance Committee, and the American
Bar Association Tort and Insurance Practices Committee. He
has also served as a speaker and panelist at the EEC Conference.
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Robert Leveque, Unum Group 5.3
Bob is an AVP of STD claims with Unum and has been in the
insurance industry for 24 years. He has served in various
finance, customer service and claims management roles in addition
to being actively involved with the Eastern Claim Conference
and International Claim Association. Bob has a BS degree in
Biology from Tufts University and received his MBA from the
University of Maine, Orono.
Valerie Loftin, Lincoln Financial Group 2.10, 7.2
Ms. Loftin is Vice President of Claims for Lincoln Financial
Groupin Greensboro, North Carolina. Formerly an insurance
defense attorney and appellate litigator in Baltimore, Maryland,
Valerie has held numerous positions within the insurance industry
including Claims Counsel for Nationwide Insurance, President
of Jefferson Pilot Fire and Casualty Company and Mergers &
Acquisitions/Litigation Counsel for Jefferson Pilot Corp.
Valerie has testified on behalf of the North Carolina Attorney
General's office and the North Carolina State Bar as an expert
in good faith claims handling and holds Series 6 and CPCU
designations, as well as a juris doctorate degree from the
University of North Carolina at Chapel Hill.
Tom Luckey, MetLife 2.10, 7.2
Tom is a Vice President in Corporate Ethics and Compliance
at MetLife. He has responsibility for all internal investigations,
as well as death claim investigations. Tom is also responsible
for field compliance reviews of sales offices, sales practice
surveillance, and new business/back office compliance for
individual insurance products. He joined MetLife in 1981,
and is active in several industry fraud groups, including
the Insurance Security Association, the Northeast Fraud Group,
and the Insurance Internal Audit Group. Tom received his BA
with Honors from SUNY Stonybrook and his MBA from New York
University. He is NASD Series 6 registered, and a Certified
Internal Auditor.
Sandy Lyall, M.Ed., LMHC, NCC, CEAP, Disability
Management Services, Inc. 2.4
Ms. Lyall has over 15 years of experience in the field of
mental health in a variety of settings. Her prior clinical
positions include working as part of a multi-disciplinary
vocational rehabilitation team in an inpatient psychiatric
hospital, short term case management, risk assessment, and
intervention with a psychiatric crisis team at a community
mental health center, consultation and assessment with the
homeless mentally ill population, and working as a counselor
within an employee assistance program that serviced a wide
variety of employment entities. Since 2000, Ms. Lyall has
worked as a psychiatric disability consultant with DMS. Ms.
Lyall has reviewed hundreds of disability claims in coordination
with claim professionals. Her work frequently involves contact
with the attending physician as well as the claimant, including
face-to-face interviews. Ms. Lyall earned her Bachelor’s
Degree in psychology from the State University of New York
College at Fredonia and her Master’s Degree in Counseling
Psychology from Springfield College. Ms. Lyall is also a Licensed
Mental Health Counselor, a National Board Certified Counselor
and a Certified Employee Assistance Professional.
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Leo A. Maes Jr. VP of Healthcare Solutions, HOV Services
3.7, 5.9
Leo has 26 years experience in the Health care industry having
worked with Equitable Life assurance, Principal Financial
Group, John Alden Life and PacificCare Health Systems. In
addition to his insurance claims experience he has experience
working in the insurance new business, customer service, audit
and training areas. He has an internal partnership with Medical
Management, provider contracting and Finance.
Brad Manning, American National Insurance Company 1.9, 2.2
Brad Manning holds the position of Assistant Vice-President,
Life Insurance & Annuity Claims Division with American
National Insurance Company headquartered on Galveston Island,
TX. Brad has spent his entire 17 year career with American
National. After a brief 4 year period managing litigation
in the Health Claims Department he transitioned to the Life
Claims arena. Since becoming a member of the Life Insurance
& Annuity Claims Division he has held the positions of
Claims Consultant, Manager, General Manager and in 2002 assumed
the duties of the Assistant Vice-President.Brad prides his
relationship with the United Way as a "Leader in Giving"
member and volunteering his time and effort to the Junior
Achievement program which educates the youth on the economics
of life.
Harry Markland, CFE, FLCS, Genworth 2.6, 4.6, 7.4
Harry is the Investigations Leader for Genworth Financial.
He works from Genworth’s corporate headquarters in Richmond,
Virginia and oversees the investigative efforts across business
lines, including long term care. Harry has been in the insurance
industry for 14 years and has earned the professional designation
as a Certified Fraud Examiner (CFE), and Fraud Claim Law Specialist
(FCLS) from the American Educational Institute. He is retired
from the Baltimore County Police Department where he served
in the Technical and Economic Crimes Unit. He is a member
of the International Association of Special Investigation
Units and is a past speaker at the New Jersey Special Investigators
Association and the Association of Home Office Underwriters.
Richard J. Marquez, CFE, Prudential Financial
1.1, 4.1
Richard J. Marquez is Consulting Director of Special Investigations
for Prudential Financial, where he has been employed for 26
years. Mr. Marquez is a nationally recognized expert in Internet
technology, information research, and financial investigations.
He is recognized as an expert in conducting foreign investigations
having handled investigations in every part of the world.
He has developed an extensive network of foreign investigators
and law-enforcement contacts. His technology and investigative
background have been instrumental in creating innovative processes
to combat fraud. He has been a frequent presenter and lecturer
on the subjects at numerous fraud and educational conferences
across the country and has authored several articles on the
subjects. Mr. Marquez is a graduate of The University of North
Texas where he obtained a Bachelor’s of Business Degree.
He is responsible for directing all foreign investigations
for Prudential Financial Individual Life Insurance Division.
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Cynthia Maskol, OM Financial Life Insurance Company 4.11
Ms. Maskol is Assistant Vice President and Assistant General
Counsel of Old Mutual US, responsible for oversight and management
of litigation nationally for its three insurance company subsidiaries
and nineteen asset management and investment strategy firm
affiliates.
Richard McNally, Western Reserve Life Assurance Company
of Ohio 6.10
Richard is an Attorney for Western Reserve Life Assurance
Co. of Ohio, a member of the AEGON group. He has an FLHC with
the International Claim Association and has completed his
Associate designations in Customer Service, Insurance Regulatory
Compliance and Insurance Agency Administration with the Life
Office Management Association. He also holds licenses 6 and
26 with the NASD. He is a member of the Florida Bar.
Tony Merlo, Health Dialog 6.5
Tony Merlo is Client Services National Practice Leader responsible
for overseeing all aspects of relationships with several Health
Dialog clients and for leading a team that works on developing
expanded health and productivity programs for implementation
with all employers receiving Health Dialog services. He began
his career in strategy consulting with McKinsey & Company
in New York City, working with clients in a wide variety of
industries and markets. He also co-founded Selkirk Associates,
software and consulting firm, which pioneered delivering customer
relationship management tools for use on personal computers.
Kenneth Mitchell, PhD., Unum Group 5.3
Kenneth Mitchell received his Ph.D. from the Pennsylvania
State University and served for seven years as an assistant
and tenured associate professor in the School of Medicine,
University of North Carolina, and Chapel Hill. He has served
as the Director of Rehabilitation for the Ohio Industrial
Commission and as the Executive Director of the International
Center for Industry, Labor and Rehabilitation based in Columbus,
Ohio. Dr. Mitchell has been an International Visiting Fellow
for the World Rehabilitation Fund as well as a consultant
to the Worker’s Compensation and Rehabilitation Commission
of Western Australia. He currently is a research advisor to
Unum’s Centre for Psychosocial and Disability Research
at Cardiff University, Cardiff, Wales in addition to serving
as Vice President, Health & Productivity for the Unum
Group. In this role, he provides program development services
to large multidivisional employers.
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Pam Newby, RN, Country Insurance & Financial Services
6.4
Pam is a Senior Utilization Management RN in the Life and
Disability Claims area of Country Insurance and Financial
Services. She has provided case management oversight at Country
since 1998 for group and individual disability claims. During
her employment with Country she has earned the designations
of Health Insurance Associate, Long-Term Care Professional
, Disability Health Professional, and Registered Health Underwriter.
She is a graduate of St. Francis School of Nursing in 1976.
Her clinical arena included many years in the Emergency Department/Trauma
Services. Later, she became the coordinator for the Occupational
Medicine Center and has worked for Hines and Associates as
a Case Manager.
Lisa A. Newell, FLMI, ALHC, Disability Management Services,
Inc. 2.4
Lisa has 19 years of experience in the disability insurance
claim arena. She began her career as a Claim Representative
for Paul Revere Life Insurance Company in 1988 where she later
led a team that developed and established Paul Revere’s
Psychiatric Claim Unit. In 1997 she joined Psychiatric Disability
Consultants. From 1997-2001, her role with PDC included providing
claim consulting services to PDC’s IDI and LTD clients,
developing and presenting several individual and group disability
training modules, managing PDC’s psychological consultants,
and enhancing and developing PDC programs. Since 2001 Lisa’s
responsibilities include managing psychiatric and complex
medical claims for DMS as well as consulting, training, and
project management. Lisa has presented at several industry
conferences, including the ECC and ICA. She is a Cum Laude
graduate of Smith College in Northampton, MA.
Mike O’Brien, CISP, CRSP, BISYS Retirement
Services 3.2
Mike is the director of resource development and product management
at BISYS Retirement Services located in Brainerd MN. He also
serves on the Certified IRA Services Professional Advisory
Board and the ABA Trust and investments editorial advisory
board.
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Angela Papaioannou, Sedgwick CMS 1.3
Angela is an Operations Manager at Sedgwick CMS. Her area
of expertise is Group Disability. For the past several years,
she has been involved in assisting both internal and external
customers improve and reach higher standards of quality in
their organizations.
Nimesh Patel, J.D., Unum Group 4.2
Nimesh is an Assistant Vice President & Counsel with
Unum's Legal Consulting Practice, specializing in employee
benefits law, including the ERISA, tax and insurance laws
applicable to employer-sponsored benefit plans. Nimish holds
a B.S. in Business Administration from the University of South
Florida, a J.D. from the University of Arkansas School of
Law and a LL.M. in taxation from the University of Denver
College of Law.
Kristina B. Pett, Pett, Furman & Jacobson PL 2.11
Kristina is a managing member of Pett, Furman & Jacobson
PL concentrating her practice in the defense of life, health
and disability companies in a wide range of areas. Kristina
practices in state and federal court at both the trial and
appellate levels. She has spoken at the Eastern Claims Conference,
ICA Annual Meetings and the American Conference Institute
regarding a variety of life, health, disability, and ERISA
topics and has also authored numerous publications on a variety
of topics including ERISA and Title VII issues. Kristina graduated
cum laude from the Temple University School of Law and obtained
her Bachelors of Arts degree from the George Washington University.
She is a member of the Trial Lawyers Section of the Florida
Bar and a member of the Life, Health & Disability Committee
of the Defense Research Institute.
Keith Perkins, Lincoln Heritage Life Insurance
Company 2.2, 6.1, 6.7
Keith is Vice President of Lincoln Heritage Life Insurance
Company in Phoenix, Arizona. Keith has been involved in life
insurance claims for nineteen years, and he has been involved
with the ICA for several years on the life insurance committee.
He has a management degree from Arizona State University as
well as his ALHC, FLMI, and ACS designations.
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M. Lisa Phillips, ALHC, Allianz Life Insurance Company
1.10, 2.1, 5.8, 6.9, 7.7
Lisa has been in the insurance claims industry for 30 years
with experience in Life, Disability Income, Social Security
Disability, Long Term Care and Annuity Claims. She currently
manages the Life, LTC and Annuity Claim teams at Allianz Life.
She is an active participant in ICA having served on various
committees over the past 6 years including the Life, Fraud,
Nominating and Annual Meeting Team Committees.
Lisa Piechowski, PhD., ABPP, Psychiatric Disability Consultants
Mgmt. Services, Inc. 2.4
Dr. Piechowski is a board certified forensic psychologist
specializing in disability, worker's compensation, and employment
litigation. Since 1998, Dr. Piechowski has worked as an independent
evaluator and a consultant for a broad range of disability
insurance companies. She is the author of a number of related
articles and the forthcoming book Best Practices in Forensic
Psychology: Evaluation of Workplace Disability: Independent
Medical Examinations (Oxford University Press). Dr. Piechowski
is active in many national organizations, currently serving
as the treasurer of the American Academy of Forensic Psychology
and on the American Psychological Association Committee on
Professional Practice & Standards.
Phil Porter, Principal Financial Group 2.8
Phil has 20+ years of leadership and management experience
at the Principal. He is responsible for Individual Disability
Claims and Shared Technical Claims Resources at Principal.
Prior to his current assignment, Phil attained technical knowledge
and held management positions with property/casualty, Group
and Individual Long Term Care and Individual Life product
lines. Phil earned Bachelor of Arts degrees in Economics and
Business Administration from Wartburg College in Waverly,
IA.
John Prange, Smart Data Solutions 5.5
John is the founder and part owner of Smart Data Solutions
where he leads the technical, operational and strategic aspects
of SDS. John’s background includes extensive experience
in both healthcare and systems operations. John founded Smart
Data Solutions with the vision of taking a more “intelligent”
approach to front-end operations. Specifically, through understanding
mailroom, claims payment and technical systems, SDS can provide
both bottom line expense reductions as well as improved downstream
process efficiencies. John earned a BS in Industrial Engineering
from the University of Wisconsin, Madison in December of 1985.
In 1998 he earned a MBA with a Systems Concentration from
the University of Minnesota.
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Brett Preston, Hill, Ward & Henderson, P.A. 2.1
Brett Preston is a litigation shareholder with Hill, Ward
& Henderson, P.A., a full service law firm in Tampa, Florida.
Brett handles a wide variety of matters, with an emphasis
in the defense of legal malpractice cases, life, health, and
disability insurance and ERISA matters, products liability
actions, and commercial litigation. He is also a certified
mediator. Brett graduated cum laude with a Bachelor's degree
in Religion from Duke University in 1983. He received his
J.D. from Washington University in St. Louis in 1986, where
he served on the law review and graduated Order of the Coif.
Brett is active in the FDCC, DRI, ICA, and ABA, and is a frequent
public speaker on legal and ethical issues in his areas of
practice.
Peter R. Reilly, M.S., Dynamic Claims Solutions 1.5
Peter R. Reilly, M.S., is the President and Director of Injury
Analysis for Dynamic Claims Solutions of Palm Coast, Florida.
Over the past 16 years he has analyzed several thousand psychiatric
and neuropsychological injury claims, developing defense and
cross-examination strategies for defense counsel and claims
professionals. Recently, he authored the article “Debunking
Neuropsychological Injury Litigation.” He is regularly
asked to lecture on topics including Brain Injury, Evaluating
Neuropsychological Evidence and Post-traumatic Stress Disorder,
as well as Psychological Overlay and Manipulation.
Douglas A. Scullion, Gordon & Rees, LLP 1.11, 5.12
Originally from Canada, Doug practiced with Davis & Company
in Vancouver, BC from 1993 to 2000, specializing in complex
civil litigation. Doug then relocated to California, and now
practices with Gordon & Rees LLP in San Francisco. Doug
advises casualty and life, health and disability insurers
in various coverage matters and also represents insurers and
financial service providers in coverage disputes and related
proceedings. Doug is a graduate of The University of Western
Ontario and holds a law degree from the University of BC and
a Master of Laws from the University of California, Berkeley.
He is a member of the ICA, the Defense Research Institute,
the American Bar Association, and the Bar Association of San
Francisco.
Kathleen M. Serunian, Disability RMS 3.3
Kathleen is Vice President, Claims, Disability RMS. Kathy
has 22 years of experience in group disability insurance.
As Vice President of Claims, she is responsible for the strategic
and operational leadership of the Disability RMS Claims organization,
providing clients with superior claims service and risk management.Prior
to joining Disability RMS in 1994, Kathy held various claims
management positions with Unum Reinsurance. She is a summa
cum laude graduate of the University of Southern Maine, with
a bachelor’s degree in education. Kathy holds all required
Third Party Administrator state licenses.
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Jeff Shomaker, Symetra Life Insurance 4.2
Jeff is the Director of Individual Life Claims at Symetra
Life Insurance in Bellevue, WA. Symetra Financial is a nearly
50 year old company and is owned by an investor group led
by Berkshire Hathaway Inc. and White Mountains Insurance Group,
Ltd. Jeff has more 20 years of life insurance experience in
a variety of areas and has been in claims management since
1995. Jeff is a graduate of the University of Texas at Austin
and has been very involved with continuing his insurance education
by obtaining the CLU, FLHC, and FLMI designations as well
as the 6 and 63 licenses.
Jeffrey C. Small, FLMI, ALHC, ACS, Hartford Life 3.3
Jeff has 10 years of insurance claim experience. As Manager
of one of Hartford Life's Appeal Units, he is responsible
for the unit's through and true handling of Life, Premium
Waiver, AD &D, and Disabiliity appeals. Prior to joining
Hartford Life's management team, Jeff held various claim handling
and consulting roles with Unum and Allmerica. Jeff is cum
laude graduate of the University of Massachusetts.
Craig A. Smith, Advantage 2000 Consultants, Inc. 1.3
Craig has worked for Advantage 2000 Consultants, Inc. since
2002 and has 17 years of experience in the Social Security
Disability representation industry. Craig has also worked
in the financial planning and financial software industries.
Craig received his undergraduate degree from Missouri Western
State University in St. Joseph, Missouri.
Ernest Patrick Smith, CPA, CFE, Callagan
Nawrocki LLP 2.5, 5.4
Ernest is a Partner with Callaghan Nawrocki, LLP and leads
up the Special Services Practice which includes providing
Internal Audit, Internal Control Review and Evaluation, Forensic
Accounting and Risk Management Services to for-profit, not-for-profit,
insurance companies, banks and lending institutions and other
related entities. He has extensive experience as a Financial
Investigator regarding integrity, internal control and evaluation,
fraud and other related situations. He has led numerous training
services for his clients and professional staff on various
topics relating to internal audit, internal control review
and evaluation, insurance claims investigation, fraud and
forensic investigations and practice standards. He is a member
of several committees within the New York State Society of
CPA’s including the Business Valuation, Litigation Support
and the Professional Ethics Committee. He has provided assistance
to counsel, deposition testimony and trial testimony in all
aspects of litigation-related matters including mediation,
arbitration and litigation. He has been recognized as an expert
witness in accounting related matters in both federal and
state courts.
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Embert (Bert) Sosnin, Munich American Reassurance Company
4.3
Bert holds the position of Assistant Secretary – Group/Credit
Claims for Munich American Reassurance Company (4 years).
He is responsible for all claim processing and client review
initiatives for Munich American’s Group and Credit Insurance
Product lines, including Group Business Travel Accident. Prior
to joining Munich American, Bert spent 2 years at Bankers
Life Insurance Co., where he led their Credit and Ordinary
claims departments. Before Bankers Life, Bert spent 6 years
at Liberty Life Insurance where he held the position Assistant
Vice President of Managed Benefits including Life, Health
and Disability Claims. Before Liberty, Bert spent 23 years
with Aetna Life and Casualty and American Heritage Life where
he held various positions, including Vice President of Claims.
Bert holds a Bachelor of Arts degree from Northeastern University
with a dual major in Finance and Insurance.
Steve Sperka, Northwestern Mutual 2.8
Steve has been with Northwestern Mutual for 16 years. He is
currently the Director of their Disability Income Claim operations
and has been in this role for 3 years. Steve is an actuary
and prior to his current job, he performed a variety of actuarial
roles including the pricing and design of the company’s
long-term care insurance products. He is a Fellow to the Society
of Actuaries, a Chartered Life Underwriter and is currently
pursuing his MBA from the Kellogg School of Management at
Northwestern University.
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Timothy J. Springer, CFE,CIFI, FCLS, LTCP, CAMS, CFI,
John Hancock 2.6, 7.4
Mr. Springer is Manager of Claims Investigations with John
Hancock’s Investigative Services group. He is based
in the Chicago area and currently manages and conducts investigations
related to life insurance claims, disability waiver of premium
claims, long term care insurance fraud and broker/agent misconduct
violations across the country. During his 15 years in the
industry, he has specialized in many areas of insurance fraud
investigation, including bodily injury claims, auto theft,
residential theft and arson.
Mary Stolee, ALHC, FLMI, CLU, ChFC, Allianz Life Insurance
Company 5.10
Mary is the Second Vice President and Senior Managing Attorney
at Allianz Life in Golden Valley, Minnesota. She manages the
fixed product team of lawyers responsible for Life, LTC, and
Annuity product development, administration, taxation, and
claims, as well as enterprise legal issues such as anti-money
laundering and privacy. She is a member of the ICA Law Committee.
She received her B.A. from St. Olaf College, and her J.D.
from Hamline University School of Law. Before working at Allianz
Life, Mary was in private practice in the area of estate planning
and spent 14 years as counsel at Lutheran Brotherhood.
Timon V. Sullivan, Ogden & Sullivan PA 4.11
Timon V. Sullivan is a partner in Ogden & Sullivan PA, a Tampa, Florida law firm that represents clients in life, health and disability matters in state and federal courts throughout the State of Florida. Mr. Sullivan is board certified as a civil trial lawyer by The Florida Bar and is an advocate level member of the American Board of Trial Advocates.
Robert J. Swan, ALHC, Trustmark Insurance Company 4.4
Bob has over 20 years of Individual Disability Income claim
and field experience. He currently serves as the AVP of Disability
Benefits for Trustmark Insurance Company. Bob received his
undergraduate degree in Finance from Northeastern University
in Boston, MA. He is member of the New England Claim Association.
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Loraine van Eeden. Swiss Re Life & Health 6.3
Loraine joined Swiss Re Life & Health, Zurich in July
2001 as Head of Claims for Europe, Asia and Latin America
and is Member of Senior Management in Swiss Re Life &
Health, Switzerland and relocated to London as Head of L&H
claims in July 2006. She was employed by a direct insurer
in the group division in South Africa. She worked there for
25 years and has been involved in financial underwriting,
actuarial, pricing and claims management. During the 1990's,
South African Insurers experienced large losses in their disability
portfolios. Lorraine was actively involved in a claims management
project in South Africa looking for solutions to the problem
and also consulted with large corporate companies about their
claims management procedures and policies.
Kathleen Vandy, The Penn Mutual Life Insurance Company
2.11
Kate is corporate counsel at The Penn Mutual Life Insurance
Company in Horsham, PA. At Penn Mutual, Kate provides legal
advice on a wide range of issues to all areas of the organization,
including Claims, Underwriting, and New Business Departments
and overseeing litigation related to those areas. She is also
Penn Mutual’s Privacy Officer and responsible for the
company’s compliance with the federal and state privacy
laws. Kate is past President of the Greater Philadelphia Claims
Association; has earned the Associate, Life & Health Claims
designation; and holds NASD Series 7, 24, & 51 licenses.
Kate is a graduate of Mount Holyoke College and Rutgers School
of Law.
Henry C. Wang, Manatt, Phelps & Phillips
4.11
Mr. Wang is a partner at the Los Angeles office of Manatt,
Phelps & Phillips. Mr. Wang’s practice focuses on
general business litigation, with a specialty in representing
insurers in matters involving annuity, life, health, and disability
insurance.
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Rick Westwood, ExamOne, a Quest Diagnostics Subsidiary
5.8
Rick is a FLMI, and has been in the life insurance industry
for 28 years. He was with Prudential for 17 years and is now
in his 11th year with ExamOne, where he is Regional Sales
Vice President, based in Wellington, Florida. Rick is a graduate
of Rutgers University and is a member of many regional and
national life underwriting organizations. This is his first
ICA meeting.
Erin Worthington, ALHC, ACS, Allstate Life Insurance Company
2.1, 5.1, 6.2
Erin has worked for Allstate Life Insurance Company for 23
years, 12 of which have been in Claims. She is currently a
Consultant in the Life and Annuity Claim Department with Allstate,
where her responsibilities include compliance, workflow, and
quality issues. She is also a member of the company’s
Special Investigations Unit.
Donna Zeh, Sun Life Financial 2.8
Donna is currently a Benefit Consultant for Sun Life Financial,
and has been telecommuting for the last 3 years. Her group
disability experience includes 13 years at Unum, and 3 years
at Cigna. She has worked in a variety of roles including training,
mentoring, managing, appeals and litigation, and special projects.
Donna received a Bachelor of Business Administration degree
from Pace University in Pleasantville, NY.
Myra Zimmerman, FLHC, ACS, AIRC, AIAA, AIG Claim Services
3.9, 4.3, 7.1
Myra is currently the Manager of AD&D Claims for AIG Claim
Services. She has been in the “claims business”
for over 30 years, with experience in medical, life, disability
and accidental death and dismemberment claims. She is a member
of the Life Committee of the International Claims Association.
And she was a past President of the Greater Philadelphia Claims
Association. Myra has a Bachelor of Arts Degree and a Master
of Liberal Arts Degree both from the University of Pennsylvania.
She holds five professional designations: Fellow Life and
Health Claims, Associate Life and Health Claims, Associate
Customer Service, Associate Insurance Regulatory and Compliance,
and Associate Insurance Agency Administration.
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