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Manager Special Investigations Unit

Location:
Folsom, California, United States
Salary:
Open
Posted:
October 14, 2016

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Michael J Widner

**** ******** *****

Folsom, CA 95630

(916) ***-**** acw113@r.postjobfree.com

WORK EXPERIENCE:

THE HARTFORD INSURANCE COMPANY- Rancho Cordova, CA

****-*******

Territory Manager Special Investigations Unit -Western Region

Responsible for the direct supervision and overall performance of the West Territory Special Investigations Unit (SIU). Ensure a timely high quality investigative product while fostering a high performance work environment. Establish guidelines and protocols to enhance the SIU investigative direction. Duties include the supervision and coordination of investigations and consultations regarding the overall corporate direction of fraud control. Responsible for fraud detection and deterrence, composing investigative and interview protocols and direct supervision of investigators, quality assurance, expense and budget management, collaboration, and working with various claims offices, while providing fraud awareness training to our integral business partners. Highly knowledgeable in appropriate investigative techniques and strategies in all lines of insurance to include; Property and Liability, Automobile Coverage (including Bodily Injury, Medical Payment, and Auto Theft), Complex Workers Compensation, Cargo, Life, Disability, Property, Fires, and Organized Fraud Rings. Extensive experience with the laws pertaining to insurance claims, mandated reporting deadlines, good-faith investigative techniques, and understanding of emerging issues with a focus on Major Case and Medical Fraud. Assure all investigations are conducted in accordance with state law adhering to privacy and confidentiality while following corporate standards and protocols. Responsible for complying with the Department of Insurance fraud reporting requirements, and submitting the annual compliance report.

PROGRESSIVE INSURANCE COMPANY -Rancho Cordova, CA

2003 – 2007

Manager Special Investigations Unit California

Responsibilities included directing the performance of the SIU staff and investigations for

California. Accountable for team results including compliance with SIU Best Practices, quality assurance reviews, performance management and calibration of files to corporate audit standards. Established and implemented procedures for identifying potentially suspect claims, worked closely with claims management for appropriate claims resolution and provided SIU fraud awareness training. Involved with the selecting and managing of appropriate vendors including attorneys, private investigators and forensic experts. Duties included supervising the investigation of organized fraud rings, medical fraud, vehicle, boat, RV and motorcycle thefts and suspect injury claims. Extensively involved with organized fraud ring and link analysis investigations.

NATIONWIDE INSURANCE COMPANIES

1991-2003

2000-2003 SIU Manager California-Nationwide Insurance, Sacramento, CA.

Responsible for the supervision of investigations and all affiliated matters in the state of California. Extensively involved in composing various investigative guidelines policies and procedures for SIU activities including SIU Best Practices, suspect claims identification, reporting protocol and investigative requirements. Established working relationships with local, state and federal government authorities as well as civil authorities on cases suspected of insurance fraud. Responsible for providing a timely, quality investigative product to make appropriate decisions involving fraud issues. Heavily involved in the integration of SIU teams from acquired companies and creating a positive work environment.

1995-2000 SIU Western Zone Manager, Phoenix, AZ. and Anaheim, CA

Responsible for the development of a Special Investigations Unit for the western states zone, which included: California, Washington, Oregon, Nevada, Colorado, Utah and Arizona. This included recruiting, hiring and training SIU staff throughout the west. Composed policies, procedures and guidelines and implemented the SIU in accordance with corporate fraud objectives. Submitted state required fraud plans for all the western states, budget preparation, and maintenance and development of internal fraud plans.

1991-1995 Senior Supervising Special Investigator

Established and implemented an SIU program in Texas.

Assisted in the selection of new personnel and provided on the job training and supervision. Conducted investigations in all areas of commercial and personal lines.

Heavy interaction with law enforcement and regulatory agencies.

EDUCATION:

Bachelor of Science in Criminal Justice- University of Texas at El Paso

Life Management Institute

Fraud Claim Law Specialist Designation

Certified Insurance Fraud Investigator

INDUSTRY AFFILIATIONS:

Northern California Fraud Investigator Association

International Association of Special Investigation Units (IASIU)

Insurance Fraud Advisory Board

NICB Medical Fraud Task Force-Northern and Southern California

REFERENCES:

Robert Burcina JD (707) ***-****

David McDowell Senior Partner McDowell, Shaw and Garcia (925)***-****

Michael Izuno (323) ***-****



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