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Ricardo Casares Cebrecos

Ricardo C. Cebrecos

AudaMedic Director
Solera Technology

Ricardo Casares Cebrecos

Ricardo C. Cebrecos

AudaMedic Director
Solera Technology

A Statistical Approach to Fraud, Waste & Abuse in Healthcare

An actuary with 33 years of experience in the insurance industry, Ricardo has collaborated with senior life and health insurance executives from numerous insurance and reinsurance companies, including: GNP, Salud Comercial América (ISES), New York Life, Munich Re, and Partner Re. His responsibilities include the areas of new products, actuarial, pricing, analytics, reinsurance, marketing, operations, commercial, and strategy for both lines of business.

Among his main achievements are reaching a market share of +50% with Línea Azul (GNP); design and development of a complete health claims area for New York Life (2010-2012); along with defining, negotiating, and implementing cost containment strategies for the health insurance sector that led to sustained growth and profitability.

Colin DeForge

Colin DeForge

Executive Director, Underwriting
RGA
 


 

 

 

 

Colin DeForge

Colin DeForge

Executive Director, Underwriting
RGA
 


 

 

 

 

The Ever-Evolving World of COVID and Fraud and Its Impact on the Insurance Business

In his role as Executive Director, Underwriting within RGA’s U.S. Facultative Underwriting unit, Colin DeForge is responsible for facultative underwriting and is also the lead for RGA’s fraud, criminal history and credit reporting team. He joined RGA in 2015. 

Prior to joining RGA, Colin was Director, Individual Life Underwriting Shared Services at Voya Financial. He has also served as underwriting manager for Phoenix Life Insurance Company in underwriting and life new business operations. 

Colin received a B.S. in psychology from the University of Massachusetts Amherst, with minors in neuropsychology and business management. He serves as President on the executive board of the Hartford/ Springfield Underwriting Association. 

Kristin Fiano

Kristin Fiano, Ph.D.

Clinical Director of Neuropsychology
PsyBar
 


 

 

 

 

Kristin Fiano

Kristin Fiano, Ph.D.

Clinical Director of Neuropsychology
PsyBar
 


 

 

 

 

COVID and the Brain: What We Know from the Early Research

Dr. Kristin Fiano is the Clinical Director of Neuropsychology at PsyBar. She earned her Ph.D. in psychology from the University of Florida in 1994.  She became board certified in clinical neuropsychology in 2005 through the American Board of Clinical Neuropsychology.  She has run her own private practice for more than 20 years, specializing in neuropsychological evaluations and forensic assessments. 

In her work with PsyBar, she has performed numerous independent medical evaluations and fitness for duty evaluations.  She has provided quality assurance services for PsyBar for several years, and in 2020 was promoted to her current position. 

Melissa Glynn

Melissa Glynn

Head of Fraud Operations and Controls
MassMutual


 

 

 

 

Melissa Glynn

Melissa Glynn

Head of Fraud Operations and Controls
MassMutual


 

 

 

 

Agent Fraud: A Case Study in How Fraudsters Impersonate Agents to Commit Fraud and How MassMutual is Combatting this Threat

Melissa Glynn is Head of Fraud Operations and Controls for MassMutual and is responsible for developing strategies and implementing capabilities and controls to proactively prevent and detect threats of internal and external fraud, leveraging data-driven monitoring and analytics to continually assess and improve capability and control performance based on progressive learnings, and responding quickly and effectively to mitigate active fraud events. 

Melissa has been at MassMutual for 15 years, primarily in risk and control functions including Fraud, Regulatory Risk and Controls, Financial Controls and Finance. Prior to MassMutual, she worked in Corporate Finance at Liberty Mutual and was previously a consultant for EY in their Fraud Investigation and Dispute Services practice. 

Melissa graduated cum laude from the University of Massachusetts Amherst with a Bachelor of Business Administration. 

 

Bill Hittler

Bill Hittler

Attorney
Nilan Johnson Lewis PA


 

 

 

 

Bill Hittler

Bill Hittler

Attorney
Nilan Johnson Lewis PA


 

 

 

 

The Ever-Evolving World of COVID and Fraud and Its Impact on the Insurance Business

Bill Hittler is an attorney with Nilan Johnson Lewis PA in Minneapolis, Minnesota and a Notre Dame Law School graduate. He works in the ERISA benefits, reinsurance, and health care litigation areas, as well as non-ERISA case law where insurance policies are issued to individuals or are exempt from ERISA because they are governmental or church plans.

Nilan Johnson’s ERISA and insurance practice group works with insurers, administrators, employers and medical evaluators across the United States; and state compliance and regulatory matters.

On the non-professional side, Bill volunteers as a kindergarten mentor with Sheridan and Cityview Elementary Schools, is a Board member of the Alan Page Education Foundation, and a Scout Leader.

Char Hu, PhD

Char Hu, Ph.D.

CEO
The Helper Bees
 


 

 

 

 

Char Hu, PhD

Char Hu, Ph.D.

CEO
The Helper Bees
 


 

 

 

 

Applications of Digital Data for Fraud and Outlier Detection in Long-Term Care

Dr. Char Hu is the CEO and founder of The Helper Bees, a company dedicated to empowering older adults throughout the aging-in-place journey. His path to the world of memory care began with his own grandmother’s Alzheimer’s diagnosis. When she was diagnosed, he was completing his doctoral research in the underlying mechanisms for Alzheimer's and dementia. This experience of caring for her lead him to co-found Georgetown Living, a facility certified in Alzheimer's and dementia care and known for evidence-based design and pet therapy with ranch animals.

Five years later, he founded The Helper Bees (THB) after recognizing that in-home care for seniors needed a major remodel. Headquartered in Austin, TX, THB is now an industry-leading insurtech and care management company using data-driven tools to deliver in-home care and personalized interventions. Dr. Hu also organized partnerships with some of the world's largest insurance carriers and health plans to reduce claims costs. Dr. Hu takes pride in being an active member of the community where he serves on several non-profit boards with the shared mission of delivering excellent services to older adults in need.

Marilda Kotze

Marilda Kotze

Vice President, Head of Global Claims
RGA


 

 

 

 

Marilda Kotze

Marilda Kotze

Vice President, Head of Global Claims
RGA


 

 

 

 

The Ever-Evolving World of COVID and Fraud and Its Impact on the Insurance Business

Marilda Kotze is Vice President, Head of Claims for RGA and part of the Global Support Team. In this role, she is responsible for supporting RGA global offices in delivering high-quality claims services to local clients. Marilda has been in her current role since October, 2017, and has been with the company since 2012. Prior to joining RGA, she had more than 14 years of international reinsurance experience working in various sectors of the insurance industry, including disability management consulting and health management services. 

Marilda has a bachelor’s degree in occupational therapy and represents RGA on various industry committees, including having served as the convener of the Association for Savings and Investment South Africa (ASISA) Claims Standing Committee, and being a past member of the ASISA Scientific Sub Committee and Main Organising Committee for the Underwriting and Claims Conference (AUCC). 

Josh Morrill

Josh Morrill

Supervisory Special Agent
Federal Bureau of Investigation, St. Louis Division
 


 

 

 

 

Josh Morrill

Josh Morrill

Supervisory Special Agent
Federal Bureau of Investigation, St. Louis Division
 


 

 

 

 

Evolution of the Online Scam

Josh Morrill is a Supervisory Special Agent at the St. Louis Division of the Federal Bureau of Investigation with the primary responsibility of leading the financial crimes programs. The objective of this program is to disrupt and dismantle major economic crime and health care fraud schemes occurring throughout eastern Missouri. SSA Morrill also serves as the SWAT Coordinator for the St. Louis SWAT team and provides oversight to the recruiting program.

Prior to his transfer to St. Louis Field Office, SSA Morrill worked at FBI Headquarters as a Program Manager within the Civil Rights Unit, where he responded to major crisis events to include the Unite the Right rally in Charlottesville, VA and the Tree of Life Synagogue Shooting in Pittsburgh, PA. Josh's career with the FBI began in Baton Rouge, Louisiana as a case agent where he investigated and prosecuted financial crimes and civil rights violations.

Born and raised in Springfield, Missouri, Josh obtained degrees in accounting and business management from Evangel University and obtained his CPA license in 2007 through the state of Missouri. Prior to the Bureau, Josh worked in both the public accounting and non-for-profit healthcare industries.

Trey Reynolds

Trey Reynolds

Executive Vice President, Strategy & New Business Development
MIB Group, Inc.
 

 

 

 

Trey Reynolds

Trey Reynolds

Executive Vice President, Strategy & New Business Development
MIB Group, Inc.
 

 

 

 

Jumbo Treaty Breaches: A Multibillion-Dollar Exposure Solved

Trey joined MIB in 2020 as Executive Vice President, Strategy & New Business Development. In this new role, he is responsible for leading MIB’s strategy and new business development teams, focusing on innovation, partnership and bringing to market new value-added products and services.

Prior to joining MIB, Trey served as Head of Life Insurance Distribution at Equitable, National Sales Vice President at John Hancock, Executive Vice President at Crump, and President of BRAMCO Financial Services.

He brings over 30 years of experience in the insurance industry and holds an M.B.A. and B.A. in Accounting, both from the University of Utah. Trey is a Certified Public Accountant (CPA), has life and health insurance licenses, and holds FINRA Series 6 and 63 designations.

Larry Ryan

Larry Ryan

Vice President, Group Re Operations
RGA  


 

 

 

 

Larry Ryan

Larry Ryan

Vice President, Group Re Operations
RGA  


 

 

 

 

The Ever-Evolving World of COVID and Fraud and Its Impact on the Insurance Business

Larry Ryan is Vice President, Group Re Operations. In this role, he is responsible for the service and production of claim professionals, improving department visibility through value added services, and improving the quality of treaty development. 

Prior to joining RGA in 2020, Larry worked in the insurance and financial fields in roles that include Vice President, Operations, Director, Appeals and Litigation, and Claims Market Manager. In these positions, he gained over 27 years of leadership and management experience in areas including life, accident and disability (LAD), absence management, litigation, quality assurance, and property and casualty claims.

Larry received a Bachelor of Art (B.A.) degree in Political Science from Slippery Rock University in Butler County, Pennsylvania and holds a Juris Doctor (J.D.) Degree from Temple University in Philadelphia, Pennsylvania. 

Emily Schultz

Emily Schultz

Senior Claims and Litigation Counsel
RGA  


 

 

 

 

Emily Schultz

Emily Schultz

Senior Claims and Litigation Counsel
RGA  


 

 

 

 

The Ever-Evolving World of COVID and Fraud and Its Impact on the Insurance Business

Emily Schultz, JD, is Senior Claims and Litigation Counsel for RGA Enterprise Services Company where she is responsible for disputes, litigation and claims. She has been with the company since 2020, and has more than 20 years of experience in general litigation across a broad spectrum of specialties, including commercial transactions, intellectual property, licensing and distribution, employment, legacy liabilities, insured claims, and regulatory compliance.

Prior to joining RGA, Emily was Associate General Counsel for Caleres, Inc., and has also served as an Associate Attorney for Greensfelder, Hemker & Gale, P.C. and for Winston & Strawn, LLP.

Emily received her Juris Doctor degree from the University of Illinois in Champaign-Urbana, and holds a Bachelor of Music degree from Baylor University.

Matthew Smith

Matthew J. Smith

Executive Director
Coalition Against Insurance Fraud 

Matthew Smith

Matthew J. Smith

Executive Director
Coalition Against Insurance Fraud 

Charting a Clear Vision for Fighting Insurance Fraud – Issues and Challenges in Decade of the 2020s

Matthew Smith is the Executive Director of The Coalition Against Insurance Fraud based in Washington, D.C. He previously served as Director of Government Affairs & General Counsel. Mr. Smith joined The Coalition staff after retiring as President of Smith, Rolfes & Skavdahl Company, LPA. He founded the firm in 1989 which grew into a national practice providing insurance law services throughout the United States and Puerto Rico. Mr. Smith also served as Legal Advisor to The Coalition.

Originally from Dayton, Ohio, Mr. Smith is a graduate of the University of Cincinnati College Conservatory of Music with a degree in Radio, TV and Film. While working his way through college and law school he served as Director of Marketing Communications for the Kings Island Theme Park Complex in Ohio and founded Smith Kaufman Public Relations representing such companies as Wendy’s International, Hyatt Hotels and The Cincinnati Reds.

Mr. Smith graduated from the Salmon P. Chase College of Law at Northern Kentucky University. He has been admitted to practice in both federal and state courts in Ohio, Florida, Kentucky, Michigan and Washington, D.C. as well as the United States Supreme Court.

He is a past President of the National Society of Professional Insurance Investigators, the Founding Chair of the Insurance Committee of the International Association of Arson Investigators, and a member of the Defense Research Institute, Claims and Litigation Management Alliance and numerous other insurance law related organizations. Mr. Smith is a frequent lecturer on insurance law matters throughout the United States. 

Robyn Wallner

Robyn Wallner

Vice President and Chief Underwriter
Ameritas


 

 

Robyn Wallner

Robyn Wallner

Vice President and Chief Underwriter
Ameritas


 

 

Traveling Through Fraud: What Does It Look Like Today?

Robyn has worked in the insurance and financial services industry for more than three decades.  She is currently VP, Chief Underwriter, Independent Distribution for Ameritas Life Ins. Corp.

Robyn graduated from the College of St. Benedict with a major in Management.  She started her career as an individual life and disability income underwriter and has progressed through many roles in life and health organizations.  Her experience includes technical underwriting (guidelines, requirements, programs), reinsurance, claims, operations management, human resources management, and technology transformation.

One of Robyn’s area of focus and interest is contestable claims, fraud, rescissions and underwriting expertise and representation for litigated cases.

She has also served on several industry committees for AHOU and ALU.

Robyn enjoys volunteering as an alpine patroller (snow boarder of course), EMT events, golfing, hiking and most importantly, spending time with her husband, Steve and three children, Paige, Megan and Matthew.

 

Collin Weston

Colin Weston

Vice President, Head of Global Health Claims
RGA UK Services Limited

 


 

 

 

 

Collin Weston

Colin Weston

Vice President, Head of Global Health Claims
RGA UK Services Limited

 


 

 

 

 

The Ever-Evolving World of COVID and Fraud and Its Impact on the Insurance Business

Colin Weston is Vice President and Head of Global Health Claims for RGA, with responsibility for health claims around the world, excluding the U.S. He joined RGA in 2008 and has almost 40 years of health insurance and reinsurance experience. 

Immediately prior to joining RGA Colin was Chief Claims Officer for European Specialty Group Reinsurance Ireland Ltd., where he was primarily responsible for books of international medical and health reinsurance, including North American-specific and aggregate medical cover. He began his career with the U.K.’s second largest specialist health insurer, working in its claims and underwriting departments, and subsequently moved to the specialist health division of a major U.K. composite company where he had responsibility for claims management and provider negotiation. During his time with the composite insurer he introduced a nurse-led helpline and procedure-based pricing.

After 11 years of direct experience Colin moved to reinsurance and has been responsible for the claims management of health-related business in many countries, including developed markets such as the U.K. and U.S., and to developing health markets in the Middle and Far East and Latin America. He also spent three years as the Managing Director of a third-party administrator (TPA) that provided TPA and training services to reinsured clients. During this period he was responsible for the specification of a health administration system that formed the basis of a product now sold by a major system house.

Previous industry appointments include Secretary of the U.K. Association of Medical Expenses Insurers, and Executive board member of the U.K.’s Anti-Fraud Association. He has worked on a number of industry groups including Managed Care and Electronic Data Interchange initiatives.

Craig Williamson

Craig Williamson

Special Investigation Unit Manager
Farmers New World Life Insurance Company

Craig Williamson

Craig Williamson

Special Investigation Unit Manager
Farmers New World Life Insurance Company

"Psychological Autopsy" A Forensic Profile in Suicide Cases

Craig began his career as an in-house investigator for a prestigious law firm in Seattle, Washington.  He moved to Southern California and held several positions of progressive responsibility for an investigative services company serving the life and health insurance industry.  Presently, he manages the Special Investigation Unit for Farmers New World Life Insurance Company and Zurich American Life Insurance Company.  In January 2012 he was appointed Head of the Fraud Expert Network for Zurich Global Life.

Craig is a graduate of Washington State University with a Bachelor of Science Degree in Police Science and obtained a Master of Arts degree in Criminal Justice at Pacific Lutheran University.  Craig has been involved in the Southern California Fraud Investigators Association (SCFIA), the Los Angeles, Orange County and the Phoenix Life & Health Claims Associations.  He obtained his Certified Fraud Examiner (CFE) credential in 2003 and an Associate of Life and Health Claims (ALHC) designation in 2009. 

In 2012 Craig was chosen to serve on the Executive Committee of the International Claims Association (ICA) where he had been an active member of the Fraud and Risk committee since 2001.  In 2014 Washington State Insurance Commissioner Mike Kreidler appointed Craig to serve on the Insurance Fraud Advisory Board for the Washington State Office of the Insurance Commissioner (OIC).   In 2020 the American Association of Suicidology Craig was certified as a Psychological Autopsy Investigator (PAI).    

Zimmerman_Dan

Dr. Daniel Zimmerman

Senior Vice President, Head of Global Medical
RGA
Zimmerman_Dan

Dr. Daniel Zimmerman

Senior Vice President, Head of Global Medical
RGA

The Ever-Evolving World of COVID and Fraud and Its Impact on the Insurance Business

Daniel Zimmerman, M.D., is Senior Vice President and Head of Global Medical, RGA Reinsurance Company. He is responsible for thought and medical leadership, case consultation, product development, client support, and internal and external education.  Additionally, he serves as editor of ReFlections, RGA’s global medical newsletter.  

He is also Managing Director of The Longer Life Foundation, www.longerlife.org. This not-for-profit collaboration between RGA and Washington University in St. Louis School of Medicine funds the study of factors that either predict the mortality and morbidity of select populations or influence improvements in longevity, health, and wellness.

Before joining RGA in 2014, Dr. Zimmerman was a medical director with Northwestern Mutual Life Insurance Company for 8 years.  Previously, he practiced primary care internal medicine and pediatrics in Tampa, Florida. 

Dr. Zimmerman received his medical degree from the University of Wisconsin School of Medicine and Public Health and his undergraduate degree in Medical Microbiology and Molecular Biology from the University of Wisconsin – Madison, Wisconsin, USA.  He has held leadership positions with the American Council of Life Insurers (ACLI), participated in program committees of the American Academy of Insurance Medicine (AAIM), and frequently represents RGA to key industry professional organizations.  He has also contributed several articles to the Journal of Insurance Medicine, OTR, and Best’s Review