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Issue link: http://seafoodbusiness.epubxp.com/i/105616
People in the News know, there probably isn't much communication between the fraud department and the claim department." If you cannot ﬁnd the carrier's special investigations unit, visit the Coalition Against Insurance Fraud, an organization that can advise speciﬁcally which law enforcement agency investigates insurance fraud. Behind the Line Continued from page 34 Chamberlain and CFO Jeﬀ Fort on matters related to GAA's growth initiatives. Previously, Heerin was president of the Aquaculture Certiﬁcation Council (ACC) before the organization was fully integrated with GAA in 2010. Marine Stewardship Council American Pride Seafoods As the new regional sales manager for American Pride Seafoods in New Bedford, Mass., Tim Benevelli is responsible for East Coast foodservice business development. A Culinary Institute of America graduate, Benevelli brings 17 years of seafood sales management experience to the position. In his career, he has helped to develop independent brands as well as private-label products. Most recently, he was regional sales manager for National Fish & Seafood for nine years. Additionally, Ed Munson joined the company as director of foodservice sales. Munson has more than 20 years of foodservice sales experience, coming from Slade Gorton & Co., where he was VP of foodservice sales, national accounts and marketing. Munson has also served as director of foodservice sales and national accounts for Contessa Premium Foods and VP of foodservice sales at Hunt-Wesson. Global Aquaculture Alliance Jim Heerin now serves as special advisor to the Global Aquaculture Alliance in St. Louis. In this role, Heerin advises Executive Director Wally Stevens, President George 56 SeaFood Business February 2013 Dr. Werner Kiene is the new chairman of the board of trustees for London-based Marine Stewardship Council. He takes over for Will Martin, who retired from the MSC board after more than a decade of service. Kiene has more than 40 years' experience in key strategic positions in global development, leading international, multi-stakeholder initiatives in the ﬁelds of food security, strengthening communities and systems for eﬀective and sustainable resource management. Key appointments include his work at the Ford Foundation, and he helped pioneer the Green Revolution for expanding food production in developing countries. SeaWeb SeaWeb in Silver Spring, Md., selected Dr. Jennifer Scott to chair its board of directors. Scott, a specialist in strategic communications, serves as the global managing director of Ogilvy Public Relations' Strategy and Planning Group and has been a member of SeaWeb's board of directors since 2010. Troughout her tenure with SeaWeb, Scott has been a leader on the board, most recently serving as chair of SeaWeb's Fundraising Advisory Committee. Previously, she was president of StrategyOne, Edelman's specialist research company, and has also worked at Shepardson Stern and Kaminsky and at Bozell/Sawyer Miller Group. because this kind of fraud diverts employers' capital from increasing payroll and growing the business." Over the past 20 years Pageler had proved fraudulent claims some 650 times in 23 states. "Most states have organized programs to deal with insurance fraud, Editor's note: Read Behind programs funded by carriers the Lines in the March issue or policy holders," he says. for other types of restaurant "Next time you're talking theft to be on the lookout for. with your insurance provider's claim examiner, ask how Contributing Editor Lauren to contact their special inves- Kramer lives in Richmond, British tigation unit. If they don't Columbia Red ﬂag alerts for workers' compensation fraud Monday morning reports: When the alleged injuries occur ﬁrst thing Monday morning, or late Friday afternoon, but are not reported until Monday. Employees might be injured over the weekend, but report ﬁctitious injuries at the workplace when they return to work. Crooked providers: When an employee's medical providers or legal consultants have a history of handling suspicious claims, it's cause for concern. Sometimes the same doctors and lawyers are used by groups of claimants. Differing descriptions: When the medical history or ﬁrst report of an injury conﬂict with the employee's description of the accident. No treatment, thanks: When claimants refuse treatment to conﬁrm the nature or extent of an injury. Unreturned calls: When claimants who are allegedly injured are difﬁcult to reach at home. Employment change: When accidents reported occur immediately before or after a strike, job termination, layoff or at the end of seasonal work. No witnesses: When the accident happened with no witnesses present and the employees' description does not logically support the cause of injury. Claims history: When the employee has a history of suspicious or litigated claims. Late reporting: When a claim is reported late without a reasonable explanation. Many changes: When the claimant has a history of frequently changing doctors, addresses and places of employment. Visit us online at www.seafoodbusiness.com