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September Issue of Risk Management Now Online

Faithful readers: the June issue of Risk Management magazine is now online. The cover story focuses on the four risks facing energy companies today and how often-overlooked areas such as commodity markets and compliance pose serious threats. Other features explore the six errors in judgement people are prone to when appraising risk and Risk Management‘s 4th annual risk management and insurance education review.

Our columns explore topics such as:

If you enjoy what you seen online, you can subscribe to the print edition to enjoy even more content.

Please let us know what you think in the comments below. And stay tuned to the blog for even more coverage in the future. Lastly, you can follow the magazine on Twitter“like” us on Facebook and join our LinkedIn group.

Q&A on Post-Catastrophe Fraud

According to a recent Munich Re finding, 2011 has become the highest-ever loss year on record due to natural catastrophes. Though most of the losses were caused by the earthquake in Japan, the U.S. has seen its share of cat losses and claims — some fraudulent. To learn more about the of post-catastrophe fraud, I questioned Gary Kerney of ISO.

After the Alabama tornadoes and the Missouri River floods, was there a dramatic increase in the amount of claims fraud?

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The recovery and rebuilding processes in many of the areas affected by severe weather this spring are only just beginning. There have been no claims fraud per se detected yet. There have been reports of fraud in previous catastrophes where property owners allegedly damaged buildings to pursue insurance claims. Such allegations were usually tied to lack of insurance. For example, much flooding occurred in areas of Louisiana caused by Hurricane Katrina. Some property owners who did not have flood insurance are alleged to have subsequently and intentionally inflicted damage to their own building to make the loss appear to be wind related because there was appropriate coverage for the wind peril.

Do you have any specific examples of claims fraud from these events that stand out in your mind?

Since there have been no large scale incidents noted yet, there are none that we can comment on specifically because it is still early in the recovery phase. As noted above, though, we can look back at other events, such as Hurricane Katrina, and find instances where reports of fraud were alleged.
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Again, much of such reported fraud activity was likely due to the absence of insurance that would normally provide money to pay for repair or replacement of damaged property. Another development that followed Katrina involved cases in which jurors reportedly felt sympathy for defendants accused of fraud – who were faced with the financial inability to repair a home or business. Some jurors were reported to have concluded they might have done the same thing under the extenuating circumstances.

Why were residents compelled to commit such fraud?

Property owners, both residential and commercial, may consider committing fraud when there is a lack of insurance or the amount of insurance is insufficient to provide for full and complete replacement or repair of the damaged property. There is a need for capital to replace the damaged structure and the lost contents. If insurance cannot fully fund the recovery, some people may consider resorting to fraudulent measures to obtain the money needed. Potential fraud activities are not only directed at insurers but can also involve attempts to obtain more money in assistance grants from government agencies such as FEMA.

How can insurers prepare for and deal with post-catastrophe claims fraud?

Insurers can anticipate some fraud activity in any kind of catastrophe ranging from a hailstorm to a hurricane. Sometimes the property owner is not aware of a fraud being perpetrated since it may in fact be the contractor or repairer who commits the fraud with inflated fees or by creating additional damage to the structure.

How can they prevent it?

Insurers take actions to reduce the impact of fraud. Adjusters are trained to identify what appear to be “red flags” for fraud. Insurers can have claims analyzed by an organization such as ClaimSearch to help identify fraud or parties to prior fraudulent schemes. Not all fraud can be prevented. However, much of it can be and is reduced through vigilance and the use of tools designed to help identity it.

What are catastrophe anti-fraud plans?

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Most insurance carriers include anti-fraud training as part of the company’s catastrophe response plan. The carriers use information developed by organization such as the National Insurance Crime Bureau to inform adjusters and others involved in the claims process regarding indicators of fraud.

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Adjusters are trained to be vigilant; however, adjusters are also expected to pay rightful claims as quickly as possible so that policyholders can begin their recovery efforts as quickly as possible. In addition, carriers often include Special Investigation Units as part of the first response to a disaster so that from the beginning the carriers can identify and react to potential fraudulent activity.
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Responses by Gary Kerney, assistant vice president of ISO’s Property Claim Services® (PCS®) division. ISO (www.iso.com) is the flagship subsidiary of Verisk Analytics (www.verisk.com).

Guest Post: Global Protests and Business Travelers

Lately, it seems as if almost every week there is a protest of some kind at some point in the world. From hundreds demonstrating against nuclear power in Madrid to protests and travel disruptions in Delhi to the deadly anti-government coup in Cairo, there is almost no corner of the world that is immune from these mass scenes of chaos, anger and extreme violence.

These protests are particularly dangerous to unsuspecting business travelers from the United States, who find themselves caught in the middle of such unrest. Business travelers going overseas, particularly to developing nations where there may be anger and resentment toward Americans, need to be knowledgeable and prepared in advance of any trip.

As a security or risk manager, you need to arm your employees with vital information and urge them to be cautious at all times. Here are some tips that you can offer employees, wherever their jobs, projects or assignments may take them:

PLAN AHEAD; ANTICIPATE A PROTEST
Prior to departure, research current news about the destination location for controversial events such as a political race or impending decision on a high-profile court case. These events are often the springboard for a protest or riot, especially in developing nations undergoing a great deal of change.

For instance, recent events include a protest that led to travel disruptions in Delhi, India, with police firing tear gas on the crowd or a protest that also became violent in Manama, Bahrain. However, no area is off-limits. One recent example was a protest outside the Libyan Embassy in Ottawa, Canada, where two were injured. Almost any kind of protest can happen anywhere and turn violent and dangerous almost instantly.

The timing and location of public protests tend to be known in advance. If travelers do their homework prior to departure, they can avoid the area or neighborhood where the protest is happening. For instance, if the hotel they plan to stay in is located within a few blocks of the protest, they can cancel that reservation and opt to stay at a hotel further away from the event.  Also, if they have business meetings at restaurants or offices around the protest area, they should consider moving the meeting to another part of the city.

If a protest is being planned, travelers should understand the nature of the riot and the attitude toward Americans so they can assess the situation’s real danger. A teachers’ protest in Wisconsin is not the same as a riot in a Third World nation that is hostile to Americans. If travelers look through the U.S. Department of State’s website (www.state.gov), they can obtain more details on particular governments and regions of the world prior to their trips.

ADOPT A “LAY LOW” MENTALITY
If an unexpected riot erupts overseas, travelers need to go into stealth mode. They should find a safe haven in the area, such as a restaurant or hotel and remain as far away from the main entrance as possible.

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The main entrances are most likely to be hit by bombs, bullets, or other weapons if the situation turns violent. They need to take off glasses, hats or anything else that identifies them in any way. Even though they may have expensive phones or cameras with them, those items need to be either hidden or simply discarded. Photographs of riots could be confiscated and used against innocent bystanders.

Travelers should remain neutral and avoid sharing their opinion of the situation.

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If a rioter begins talking to them and seeks their opinion, they should simply say they are unfamiliar with the issue. They don’t want to appear indifferent or uncaring, as that may elicit a violent response against them from an already agitated rioter.

If possible, travelers should go back to their hotels and simply remain in their rooms as much as possible during a protest.

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They should contact their corporate travel assistance provider as soon as possible, to assist them in a safe removal from the situation.

STAY AWAY FROM PUBLIC TRANSPORTATION
If there is a protest, all forms of transportation—such as buses, trains, subways, and taxis—become potential attack targets and should be avoided. Even being in a rental car is dangerous. Also, traffic is likely to come to a halt and travelers could find themselves stuck in a terrible traffic jam. If they must travel, it should be done by foot.

Local airline service is often disrupted in these situations, and travelers may need to access other area airports in order to leave an impacted area. Their ultimate goal should be to leave the area where the protests are, even if it means going to a city where they weren’t planning to do business.

Bottom line: your employees’ safety and security in these kinds of explosive situations are more important than the purpose of a business trip.

Where Questionable Insurance Claims Come From

Wanna blame someone for your high insurance premiums?

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Point to the residents of California, Florida, Texas, New York and Michigan.

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Combined, these five states generate half of the nation’s questionable insurance claims — most of which are either suspect auto policy submissions or fake injury claims.

These states account for 49 percent of all “questionable claims” as tabulated by the National Insurance Crime Bureau (NICB).

Questionable claims are those claims that NICB member insurance companies refer to NICB for closer review and investigation based upon one or more indicators of possible fraud.

NICB just released its three-year analysis of questionable claims in the United States from January 1, 2008 through December 31, 2010.

New York, Los Angeles, Houston, Tampa and Detroit are the cities generating the most QCs. Florida has three cities in the top 10 for QCs—Tampa, Miami and Orlando.

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Of course, a large reason that these states have so many fishy claims is that they are so large. Some 110 million people live in the five states mentioned.

But while they do contain about 36% of the nation’s population, that doesn’t actually explain why these locations create 49% of the questionable claims.