Luxoft Financial Crimes Intelligence (FCI) with IBM Technology

Combating Insurance Fraud with AI
Webinar Series

December 2020 – May 2021

Explore

Learn how to detect and prevent financial crime with our six-part series exploring the latest advancements in AI.

IBM

Learn More about Luxoft Financial Crimes (FCI) with IBM Technology

An overview of the AI-powered application used for enhancing and managing fraud detection.

Event Calendar

Topics

  • A plain English description of what AI is and isn’t
  • How and why FCI uses true integrated AI to enhance targeted fraud detection, rather than simply being re-badged static business rules presented as AI

Speakers

Stephen Smith, Financial Crimes Insight Sales Leader, IBM

 

Stephen specializes in Data and AI solutions for Financial Crimes, Insurance Fraud, Payments Fraud, Advanced Analytics, Information Management & Governance and Big Data. He has over 20 years of IT software sales, delivery and consulting experience. Over the last 10 years, he has been working with clients at IBM to effectively define, propose and ensure successful implementation delivery of technology-based solutions. Stephen brings IBM counter fraud technology to the insurance market, leading go-to-market efforts in North America and helping IBM teams around the world as a key member of the IBM RegTech Financial Crimes business.

Matthew J. Smith, Executive Director, The Coalition Against Insurance Fraud

 

Matthew is the Executive Director of The Coalition Against Insurance Fraud based in Washington, D.C. He previously served as Director of Government Affairs and General Counsel. Matthew 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. Matthew also served as Legal Advisor to The Coalition.

 

Originally from Dayton, Ohio, Matthew 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.

 

Matthew 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. Matthew is a frequent lecturer on insurance law matters throughout the United States.

Franklin Pinder, Senior Director, Insurance Analytics and Financial Crimes, Luxoft

 

Frank has over 25 years’ experience in the property and casualty, life, disability and accident, and health insurance industries with extensive insurance fraud, claims, operations and analytics experience. Prior to joining Luxoft, Frank served as the Director Global Financial Crimes leader at IBM from 2014 to 2020. Additionally, Frank led the Fraud and Financial Crimes consulting practice in IBM’s Global Business Services. In this capacity, Frank oversaw the development of the Financial Crimes Insights product, leading the go-to market strategy, sales organization and subject matter experts. Prior to joining IBM, Frank served as President and CEO of the largest privately held insurance counter-fraud outsourcing company from 1995 to 2014, providing structured cost containment and regulatory compliance counter-fraud solutions to insurance companies, third-party administrators, multi-national corporations and public entities. With a staff of close to 500 counter-fraud personnel, the company designed and implemented counter-fraud programs for 72 insurance carriers, third-party administrators, state and local governments and multinational corporations in the US, UK, Europe, Latin America and Australia.

Wade Wickre, Insurance Financial Crimes Leader, IBM

 

Wade joined IBM in January 2019 and leads the Insurance Financial Crime team in North America. Wade works closely with insurers, insurance industry organizations and IBM to focus attention on current and future capabilities, including artificial intelligence, analytics and shaping investigative trends for future success. Before IBM, Wade was Special Investigative Unit (SIU) Director for the Southeast United States at Nationwide Insurance and worked in varying SIU roles of responsibility for 27 years. During his SIU work, Wade served as President of the International Association of Special Investigation Units (IASIU) for 5 years and as Vice President for 4 years. During his tenure, IASIU’s membership grew with members from 27 countries to make it the largest association of insurance fraud investigators in the world.

Glen Marr, Insurance Financial Crimes Leader, IBM Europe

 

Glen joined IBM in January 2019. He is an insurance fraud domain expert, with many years of experience in tackling insurance fraud in the UK, Europe and Australia. The depth and breadth of his experience and insight in dealing with insurance fraud is extensive. During his career, Glen has held counter-fraud and wider financial crime roles with insurers, including executive director positions and as the director leading the UK Insurance Fraud Bureau and its strategy to disrupt organized insurance fraud. He has been involved in the ground-up build and leadership of very successful and award-winning counter-fraud operating models for insurers, such as the Insurance Fraud Bureau and other milestone industry initiatives, including the first insurer-funded City of London Police Insurance Fraud Enforcement Department.

Martijn Wiertz, Principal Presales Consultant, IBM

 

Martijn has 20 years' experience in the field of advanced analytics, his main focus for the last 11 years has been with insurance clients. He works closely with IBM and Luxoft teams, combining his technical, analytical and industry knowledge to help understand the unique value the FCI solution can bring to combating insurance fraud. He also has an in-depth knowledge of how the insurance industry fights fraud.

Paul Hewitt, Director and Practice Lead for AI, ML and Big Data, Luxoft

 

Paul’s role is Practice Lead for the Data, Analytics and AI and Machine Learning Practice, within Luxoft Financial Services. He has global responsibility for all Analytics, AI, ML and Big Data projects. Deliveries include full-scale AI and Machine Learning projects, in conjunction with the various global Delivery Teams, as well as Research & Development on behalf of clients, and Proofs of Concept.

Topics

  • How and why does use of AI in FCI drive material benefits in mitigating insurance fraud?
  • What are the full range of benefits attributable to FCI AI when used to tackle fraud?

Speakers

Celeste Dodson, President of the International Association of Special Investigation Units (IASIU)

 

Celeste is President of the International Association of Special Investigation Units (IASIU), where she leads the 4,000 member international organization. Their focus is on advancing excellence in the insurance fraud fighting community through education, training, awareness, and connection. She has over 20 years’ experience, managing and leading SIU insurance operation in the US, including building and leading large national SIU operations. Celeste also led large complex Claims and Underwriting Departments.

 

She earned both her CPCU and FCLA designations, BS in Criminology from Florida State University, and her MBA from Villanova University; where she was awarded the Bartley Medallion. She currently also serves as Secretary of The Pennsylvania Auto Theft Prevention Authority, Advisor on NICB’s Board of Governors and the Coalition Against Insurance Fraud’s Executive Board.

Stephen Smith, Financial Crimes Insight Sales Leader, IBM

 

Stephen specializes in Data and AI solutions for Financial Crimes, Insurance Fraud, Payments Fraud, Advanced Analytics, Information Management & Governance and Big Data. He has over 20 years of IT software sales, delivery and consulting experience. Over the last 10 years, he has been working with clients at IBM to effectively define, propose and ensure successful implementation delivery of technology-based solutions. Stephen brings IBM counter fraud technology to the insurance market, leading go-to-market efforts in North America and helping IBM teams around the world as a key member of the IBM RegTech Financial Crimes business.

Franklin Pinder, Senior Director, Insurance Analytics and Financial Crimes, Luxoft

 

Frank has over 25 years’ experience in the property and casualty, life, disability and accident, and health insurance industries with extensive insurance fraud, claims, operations and analytics experience. Prior to joining Luxoft, Frank served as the Director Global Financial Crimes leader at IBM from 2014 to 2020. Additionally, Frank led the Fraud and Financial Crimes consulting practice in IBM’s Global Business Services. In this capacity, Frank oversaw the development of the Financial Crimes Insights product, leading the go-to market strategy, sales organization and subject matter experts. Prior to joining IBM, Frank served as President and CEO of the largest privately held insurance counter-fraud outsourcing company from 1995 to 2014, providing structured cost containment and regulatory compliance counter-fraud solutions to insurance companies, third-party administrators, multi-national corporations and public entities. With a staff of close to 500 counter-fraud personnel, the company designed and implemented counter-fraud programs for 72 insurance carriers, third-party administrators, state and local governments and multinational corporations in the US, UK, Europe, Latin America and Australia.

Wade Wickre, Insurance Financial Crimes Leader, IBM

 

Wade joined IBM in January 2019 and leads the Insurance Financial Crime team in North America. Wade works closely with insurers, insurance industry organizations and IBM to focus attention on current and future capabilities, including artificial intelligence, analytics and shaping investigative trends for future success. Before IBM, Wade was Special Investigative Unit (SIU) Director for the Southeast United States at Nationwide Insurance and worked in varying SIU roles of responsibility for 27 years. During his SIU work, Wade served as President of the International Association of Special Investigation Units (IASIU) for 5 years and as Vice President for 4 years. During his tenure, IASIU’s membership grew with members from 27 countries to make it the largest association of insurance fraud investigators in the world.

Glen Marr, Insurance Financial Crimes Leader, IBM Europe

 

Glen joined IBM in January 2019. He is an insurance fraud domain expert, with many years of experience in tackling insurance fraud in the UK, Europe and Australia. The depth and breadth of his experience and insight in dealing with insurance fraud is extensive. During his career, Glen has held counter-fraud and wider financial crime roles with insurers, including executive director positions and as the director leading the UK Insurance Fraud Bureau and its strategy to disrupt organized insurance fraud. He has been involved in the ground-up build and leadership of very successful and award-winning counter-fraud operating models for insurers, such as the Insurance Fraud Bureau and other milestone industry initiatives, including the first insurer-funded City of London Police Insurance Fraud Enforcement Department.

Martijn Wiertz, Principal Presales Consultant, IBM

 

Martijn has 20 years' experience in the field of advanced analytics, his main focus for the last 11 years has been with insurance clients. He works closely with IBM and Luxoft teams, combining his technical, analytical and industry knowledge to help understand the unique value the FCI solution can bring to combating insurance fraud. He also has an in-depth knowledge of how the insurance industry fights fraud.

Paul Hewitt, Director and Practice Lead for AI, ML and Big Data, Luxoft

 

Paul’s role is Practice Lead for the Data, Analytics and AI and Machine Learning Practice, within Luxoft Financial Services. He has global responsibility for all Analytics, AI, ML and Big Data projects. Deliveries include full-scale AI and Machine Learning projects, in conjunction with the various global Delivery Teams, as well as Research & Development on behalf of clients, and Proofs of Concept.

Topics

  • What disconnected and disparate counter-fraud systems, applications, tools and MI creation looks like and the business impact
  • The pros and cons of different AI options
  • Why FCI, as a one-stop claims fraud solution, drives meaningful efficiencies and benefits, helps contain costs and makes sound business sense

Speakers

Stephen Smith, Financial Crimes Insight Sales Leader, IBM

 

Stephen specializes in Data and AI solutions for Financial Crimes, Insurance Fraud, Payments Fraud, Advanced Analytics, Information Management & Governance and Big Data. He has over 20 years of IT software sales, delivery and consulting experience. Over the last 10 years, he has been working with clients at IBM to effectively define, propose and ensure successful implementation delivery of technology-based solutions. Stephen brings IBM counter fraud technology to the insurance market, leading go-to-market efforts in North America and helping IBM teams around the world as a key member of the IBM RegTech Financial Crimes business.

Franklin Pinder, Senior Director, Insurance Analytics and Financial Crimes, Luxoft

 

Frank has over 25 years’ experience in the property and casualty, life, disability and accident, and health insurance industries with extensive insurance fraud, claims, operations and analytics experience. Prior to joining Luxoft, Frank served as the Director Global Financial Crimes leader at IBM from 2014 to 2020. Additionally, Frank led the Fraud and Financial Crimes consulting practice in IBM’s Global Business Services. In this capacity, Frank oversaw the development of the Financial Crimes Insights product, leading the go-to market strategy, sales organization and subject matter experts. Prior to joining IBM, Frank served as President and CEO of the largest privately held insurance counter-fraud outsourcing company from 1995 to 2014, providing structured cost containment and regulatory compliance counter-fraud solutions to insurance companies, third-party administrators, multi-national corporations and public entities. With a staff of close to 500 counter-fraud personnel, the company designed and implemented counter-fraud programs for 72 insurance carriers, third-party administrators, state and local governments and multinational corporations in the US, UK, Europe, Latin America and Australia.

Wade Wickre, Insurance Financial Crimes Leader, IBM

 

Wade joined IBM in January 2019 and leads the Insurance Financial Crime team in North America. Wade works closely with insurers, insurance industry organizations and IBM to focus attention on current and future capabilities, including artificial intelligence, analytics and shaping investigative trends for future success. Before IBM, Wade was Special Investigative Unit (SIU) Director for the Southeast United States at Nationwide Insurance and worked in varying SIU roles of responsibility for 27 years. During his SIU work, Wade served as President of the International Association of Special Investigation Units (IASIU) for 5 years and as Vice President for 4 years. During his tenure, IASIU’s membership grew with members from 27 countries to make it the largest association of insurance fraud investigators in the world.

Glen Marr, Insurance Financial Crimes Leader, IBM Europe

 

Glen joined IBM in January 2019. He is an insurance fraud domain expert, with many years of experience in tackling insurance fraud in the UK, Europe and Australia. The depth and breadth of his experience and insight in dealing with insurance fraud is extensive. During his career, Glen has held counter-fraud and wider financial crime roles with insurers, including executive director positions and as the director leading the UK Insurance Fraud Bureau and its strategy to disrupt organized insurance fraud. He has been involved in the ground-up build and leadership of very successful and award-winning counter-fraud operating models for insurers, such as the Insurance Fraud Bureau and other milestone industry initiatives, including the first insurer-funded City of London Police Insurance Fraud Enforcement Department.

Martijn Wiertz, Principal Presales Consultant, IBM

 

Martijn has 20 years' experience in the field of advanced analytics, his main focus for the last 11 years has been with insurance clients. He works closely with IBM and Luxoft teams, combining his technical, analytical and industry knowledge to help understand the unique value the FCI solution can bring to combating insurance fraud. He also has an in-depth knowledge of how the insurance industry fights fraud.

Paul Hewitt, Director and Practice Lead for AI, ML and Big Data, Luxoft

 

Paul’s role is Practice Lead for the Data, Analytics and AI and Machine Learning Practice, within Luxoft Financial Services. He has global responsibility for all Analytics, AI, ML and Big Data projects. Deliveries include full-scale AI and Machine Learning projects, in conjunction with the various global Delivery Teams, as well as Research & Development on behalf of clients, and Proofs of Concept.

Topics

  • The different approaches to mitigating fraudulent claims across regions
  • How mature and capable are industry counter-fraud operational models?
  • What is impacting counter-fraud performance, results and progression?
  • Has AI moved from the experimental phase to implementation as part of counter-fraud strategies?

Speakers

Matthew J. Smith, Executive Director, The Coalition Against Insurance Fraud

 

Matthew is the Executive Director of The Coalition Against Insurance Fraud based in Washington, D.C. He previously served as Director of Government Affairs and General Counsel. Matthew 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. Matthew also served as Legal Advisor to The Coalition.

 

Originally from Dayton, Ohio, Matthew 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.

 

Matthew 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. Matthew is a frequent lecturer on insurance law matters throughout the United States.

Paul Hewitt, Director and Practice Lead for AI, ML and Big Data, Luxoft

 

Paul’s role is Practice Lead for the Data, Analytics and AI and Machine Learning Practice, within Luxoft Financial Services. He has global responsibility for all Analytics, AI, ML and Big Data projects. Deliveries include full-scale AI and Machine Learning projects, in conjunction with the various global Delivery Teams, as well as Research & Development on behalf of clients, and Proofs of Concept.

Franklin Pinder, Senior Director, Insurance Analytics and Financial Crimes, Luxoft

 

Frank has over 25 years’ experience in the property and casualty, life, disability and accident, and health insurance industries with extensive insurance fraud, claims, operations and analytics experience. Prior to joining Luxoft, Frank served as the Director Global Financial Crimes leader at IBM from 2014 to 2020. Additionally, Frank led the Fraud and Financial Crimes consulting practice in IBM’s Global Business Services. In this capacity, Frank oversaw the development of the Financial Crimes Insights product, leading the go-to market strategy, sales organization and subject matter experts. Prior to joining IBM, Frank served as President and CEO of the largest privately held insurance counter-fraud outsourcing company from 1995 to 2014, providing structured cost containment and regulatory compliance counter-fraud solutions to insurance companies, third-party administrators, multi-national corporations and public entities. With a staff of close to 500 counter-fraud personnel, the company designed and implemented counter-fraud programs for 72 insurance carriers, third-party administrators, state and local governments and multinational corporations in the US, UK, Europe, Latin America and Australia.

Martijn Wiertz, Principal Presales Consultant, IBM

 

Martijn has 20 years' experience in the field of advanced analytics, his main focus for the last 11 years has been with insurance clients. He works closely with IBM and Luxoft teams, combining his technical, analytical and industry knowledge to help understand the unique value the FCI solution can bring to combating insurance fraud. He also has an in-depth knowledge of how the insurance industry fights fraud.

Glen Marr, Insurance Financial Crimes Leader, IBM Europe

 

Glen joined IBM in January 2019. He is an insurance fraud domain expert, with many years of experience in tackling insurance fraud in the UK, Europe and Australia. The depth and breadth of his experience and insight in dealing with insurance fraud is extensive. During his career, Glen has held counter-fraud and wider financial crime roles with insurers, including executive director positions and as the director leading the UK Insurance Fraud Bureau and its strategy to disrupt organized insurance fraud. He has been involved in the ground-up build and leadership of very successful and award-winning counter-fraud operating models for insurers, such as the Insurance Fraud Bureau and other milestone industry initiatives, including the first insurer-funded City of London Police Insurance Fraud Enforcement Department.

Wade Wickre, Insurance Financial Crimes Leader, IBM

 

Wade joined IBM in January 2019 and leads the Insurance Financial Crime team in North America. Wade works closely with insurers, insurance industry organizations and IBM to focus attention on current and future capabilities, including artificial intelligence, analytics and shaping investigative trends for future success. Before IBM, Wade was Special Investigative Unit (SIU) Director for the Southeast United States at Nationwide Insurance and worked in varying SIU roles of responsibility for 27 years. During his SIU work, Wade served as President of the International Association of Special Investigation Units (IASIU) for 5 years and as Vice President for 4 years. During his tenure, IASIU’s membership grew with members from 27 countries to make it the largest association of insurance fraud investigators in the world.

Stephen Smith, Financial Crimes Insight Sales Leader, IBM

 

Stephen specializes in Data and AI solutions for Financial Crimes, Insurance Fraud, Payments Fraud, Advanced Analytics, Information Management & Governance and Big Data. He has over 20 years of IT software sales, delivery and consulting experience. Over the last 10 years, he has been working with clients at IBM to effectively define, propose and ensure successful implementation delivery of technology-based solutions. Stephen brings IBM counter fraud technology to the insurance market, leading go-to-market efforts in North America and helping IBM teams around the world as a key member of the IBM RegTech Financial Crimes business.

Tommy H. Hansen, Senior Consultant SIU with Insurance & Pension

 

Tommy H. Hansen is a Senior Consultant SIU with Insurance & Pension, the Danish Insurance Association since 2008 and became an IASIU member that same year. Employed with the Crime Office, the Associations’ coordinating office for all insurance-related crime: Auto theft, personal property, and personal injury, Tommy mainly works in assisting member company SIUs with fraud investigations abroad. A former intelligence operative with extensive field experience, Tommy provides investigative support via a well-established and ever-growing network, primarily in the Middle- and the Far East, the Persian Gulf but also extending to Russia, the Former Soviet Union across the Balkans, and Africa. Besides being bilingual in Danish/Swedish, Tommy is fluent in several languages and has a long experience in the field of investigating fraudulent and falsified documentation. Tommy is a board member of IASIU Europe, where he currently serves as treasurer. A decorated veteran with many honors, Tommy is also the proud recipient of the Presidential Unit Citation (USA), awarded for having served with the Danish Special Forces Contingent in “Operation Enduring Freedom”, Afghanistan 2002. Tommy is married to Katharina and lives just outside Copenhagen, Denmark.

Topics

  • What are the red flags?
  • The red flag remedies
  • Optimizing positive features of the current model
  • Delivering more from the same or less resources
  • What does good look like?
  • The business benefits

Speakers

Scott Clayton, Head of Claims Fraud, Zurich Insurance Company

 

During Scott's 34 years with Zurich, he has handled claims across all lines of business. Previously, he led the Chief Executive's complaints team and for the last 15 years, Scott has been developing and managing Zurich's claims fraud proposition in the UK. The Claims Investigation Unit has achieved notable success and industry recognition through its use of cutting-edge technology. He currently chairs Zurich's Global Counter Fraud Network and is a member of the Association of British Insurers General Insurance Fraud Committee.

Topics

  • The risks associated with inappropriate use of AI to tackle insurance fraud
  • The importance of strong AI governance, explainability, transparency, ensuring fairness and preventing unintended outcomes
  • How IBM, the independently rated global leader in AI by market share, has strongly responded to this need, and in the use of AI in FCI

Speakers

Francesca Rossi, AI Ethics Global Leader, IBM

 

Francesca is an AI scientist with over 30 years’ experience in AI research. She's had over 200 articles published in top AI journals and conferences. She also co-leads the IBM AI ethics board, and is an active participant in many global multi-stakeholder initiatives related to AI ethics. Francesca is a member of the board of directors of the Partnership on AI, representing IBM as one of the founding partners, and also an industry representative in the steering committee of the Global Partnership on AI. She is an AAAI and EurAI fellow (Association for the Advancement of AI — both worldwide and European) and will be the next president of AAAI.

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