510

Tried & True: Witness Our Winning Techniques During a Live Mock Trial.
Two-Part Class - Part 1 of 2

Ricardo M. Luces, Esq. - Partner, Roig Lawyers;
Jessica Z. Martin, Esq. - Partner, Roig Lawyers;
Michael A. Rosenberg, Esq. - Managing Partner, Roig Lawyers

Have you always wanted to see a live trial but never had the opportunity? Now is your chance! Join us for an interactive mock trial. We will go through each stage of a trial, including voir dire, opening statements, evidence, witness testimony, closing arguments, and live juror deliberations. All the presenters are practicing trial litigators - meaning our guidance is based on real-life experiences, not theoretical procedures. Attendees will leave with an appreciation of the difficulties that judges, lawyers, and juries face in presenting all relevant facts and legal arguments to ensure the just resolution of the issues involved.

520

What's in a Code? An Analysis on Personal Injury Protection Coding Denials

Teodora Siderova, Esq. - Shareholder, Kubicki Draper;
Denisha M. Lich, MS, RHIA, HRM - President, Torres-Lich & Associates, Inc.;
Hillary Lovelady, Esq. - Shareholder, Kubicki Draper;
Ava G. Mahmoudi, Esq. - Attorney, Kubicki Draper;
Marsha M. Moses, Esq. - Shareholder, Kubicki Draper;
Michael S. Walsh, Esq. - Shareholder, Kubicki Draper

This presentation will discuss the most highly litigated coding issues in the personal injury protection arena. The speakers will discuss budget neutrality, ARNP and physician assistant reductions, the Medicare Outpatient Prospective Payment System , and specific CPT/HCPC Coding denials. The course will further address recent district court opinions as well as lower court rulings.

530

Combatting Unlicensed Fraudulent Claim Activity After SB2A Statutory Changes

Kenneth Shriberg - Managing Agent, Tance Global Services;
Anthony Allogia - General Contractor, All Claims Repair, Inc.;
Chris Cury - Public Adjuster, Pinnacle Claim Services;
Jonathan Zachem, Esq. - Managing Attorney, Zachem Law, P.A.

Many policyholders are being bombarded by unscrupulous and unlicensed individuals/entities who call themselves contractors, all lines adjusters, "claim specialists", "claim experts" and "loss consultants". These unlicensed parties' involvement in the claims process can increase policyholders' lack of trust in the system, frustrated professional stakeholders, costlier claims processing, and ultimately rate increases to all Floridians. Now more than ever, after the passage of recent SB2A statutory changes, it is important that all claims handling stakeholders know how to identify and protect the P&C marketplace against this rapidly growing industry of unlicensed individuals and entities.

540

Stages of Water Claims - Past, Present and Future: A Comprehensive Review of Water Claims from First Notice of Loss to Trial and Future Outlook

Gregory Hengber, Esq. - Senior Partner, Goldstein Law Group;
Virginia Harris-Austin - Director: Special Investigations Unit, Florida Peninsula Insurance Company;
Zasha M. Rodriguez, Esq. - Senior Partner, Goldstein Law Group;
Joe Taylor - President/Owner, Joe Taylor Restoration

This presentation will address, educate and discuss how insurers currently adjust and investigate non-weather water claims, and additional tools/techniques to adjust, investigate and defend these claims. We'll examine schemes used by claimants, including insureds, public adjusters, mitigation companies, etc. and discuss defending inflated scope of repairs for damages and water mitigation. Water mitigation standards of care and Institute of Inspection, Cleaning and Restoration Certification (IIRC) will be covered along with the history, evolution and extinction of assignment of benefits. We'll close with the new legislation (Senate Bill SB 2-A) related to property claims and the future outlook resulting from Senate Bill SB 2-A.

550

Adjusting First Party Property Claims

Jonathan Hall, Esq. - Managing Attorney, Dutton Law Group;
Scott W. Dutton, Esq. - Owner and Board Certified Civil Trial Attorney, Dutton Law Group

The course will teach adjusters and examiners what to do and what not to do in adjuster first party property claims under the revised statutes. Attendees will learn valuable insight from a property insurance trial attorney about documenting the claim, handling disputes, and resolving claims for the benefit of insureds and insurers alike. Attendees will learn how to apply facts to policy conditions and exclusions, as well as loss payment and loss settlement provisions of insurance policies. Attendees will learn about relevant statutes and case law interpreting the statutes and various policy provisions relevant to claims investigations.

560

Investigating & Defending Windstorm Claims

Daniel Frates, P.E., DFE, M. ASCE - Senior Principal Engineer, Sdii Global Corporation;
Linda Berns, Esq. - Principal, Bressler Amery & Ross, P.C.;
Krista L. Elsasser, Esq. - Principal, Bressler Amery & Ross, P.C.;
Michael Shifrin, Esq. - Principal, Bressler Amery & Ross, P.C.;
Austin Flickstein, Esq. - Principal, Bressler Amery & Ross, P.C.;
Hope Zelinger, Esq. - Principal, Bressler Amery & Ross, P.C.

In the aftermath of Hurricane Ian, it is imperative that insurance carriers comply with recent legislative changes and understand what tools are available to assist with determining causation, identifying fraudulent claims, and strategies for defending claims that reach litigation.

570

Chiropractic Fraud with a Hands-On Workshop Describing a New Motor Vehicle Accident Office Visit

Juan De La Vara - Criminal Investigator II, Colorado Attorney General's Office

The presenter, a former chiropractor turned fraud investigator, will illustrate how to evaluate and examine a new chiropractic patient following evidence-based protocols. Real interaction will be demonstrated when taking a detail motor vehicle accident history, in conjunction with how to take a strong history and perform an adequate physical examination of the patient in order to provide the correct ICD 10 and CPT codes. Several neurological and orthopedic tests will be explained and demonstrated in order to ask important future investigative questions, as a result of a fraudulent activity referral.

580

Intent to Distribute - Knowledge: A Prescription to Possess the Skills for Investigating Pharmaceutical Claims

Philip L. Colesanti, Esq. - Attorney, Roig Lawyers

Prior to the 2012 No-Fault Law revision, PIP was a key contributor to the rise in the Florida pill crisis. Licensing reforms, reporting requirements and revised criteria for claim submissions have reduced the crisis. This course will bring light to new challenges created by pharmaceutical providers in the post-pill mill era. It will help SIU and litigation adjusters learn how to properly evaluate pharmacy claims from top to bottom and provide examples and tools to ensure the pharmacy pockets are not overdosed with improper benefits.