Benefits Fraud - aka STEALING!

February 19, 2020 11:30 AM to 1:30 PMRoyal Mayfair Golf Club, Edmonton, Alberta
Area of Interest: Benefits, Networking Format: In Person

According to the Canadian Health Care Anti-Fraud Association, fraudulent claims cost the industry between $1 to $6 billion every year, yet sometimes it is seen as a victimless crime affecting only insurance companies but the real truth is many in our industry are picking up the tab!

Fees and Registration
Membership Types Regular Price
Regular membership $47.62 CDN
Plan Sponsor Individual Membership $47.62 CDN
Associate $47.62 CDN
Student $33.34 CDN
Non Member $96.43 CDN
Cancellation Policy
CE Credits will be offered in partnership with the Alberta Insurance Council.

Fraud detection is becoming increasingly complex and is rapidly changing from both the member and provider perspective. In this interactive session, our keynote speakers from industry leading organizations will explore this topic as it relates to employee benefit plans, including insight into the use of data, technology and analytics to elevate detection; audit and claims assurance methods; and various approaches plan sponsors and administrators can take to prevent benefit plan abuse.

 

Gary Askin AVP

Fraud and Risk Management Sun Life Financial

As the Assistant Vice President Gary Askin provides strategic direction and day to day leadership to the Fraud Risk Management function across Canadian customer service processes, to develop detection, prevention and investigation capabilities.

The team within Operations works in partnership with internal business areas and external stakeholders such as clients, group plan members, plan sponsors, industry associations and police services to combat fraud.

Gary has been with Sun Life since September 2014 and has brought 33 years of experience from his former role as a Commander of Strategic and Tactical services with the Waterloo Regional Police Service-where he investigated and lead drug, organize d crime, terrorism, intelligence and hate crime teams and investigations.

Jil Tanguay, B.Sc. (Spec.), CFI, CRMA

Claims Audit and Investigation Services, Alberta Blue Cross

Jil has spent the last 25 years in the fraud field focusing on the health benefits industry. The last 19, directing and managing the activities at Alberta Blue Cross. He is both a Certified Forensic Investigator and holds a Certification in Risk Management Assurance. His area has two separate focuses, they are:

• Outlier detection using advanced analytics, this focuses on identifying providers and/or members where there is a potential for fraud and/or plan abuse issues, and

• Audit / investigations, that focuses on the completion of investigations of claims submitted in the Pharmacy, Dental and Health lines of business as well as member submitted claims.

Jil also maintains membership with the Institute of Internal Auditors.

He has also completed presentations on fraud, advanced analytics and risk management at National conferences over the last 15 years. He is Alberta Blue Cross’s key contributor to all Canadian Life and Health Insurance Association committees on topics of fraud and advanced analytics.


Join us at the Royal Mayfair Golf Club on Wednesday February 19, 2020 from 11:30 am - 1:30 pm. Note this session is a luncheon rather than our normal breakfast session.