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Two stories caught my interest this morning. Two stories about insurance fraud that illustrate the fraud can be perpetrated by insureds, insurers, third-parties, regulators, and just about anyone where there is money involved.

In Florida, insurer, QBE Insurance Corporation, is facing a $500 million bad faith lawsuit by a condominium association. The association’s towers were seriously damaged in a hurricane. The allegation is that the insurer, knowing the two condominium towers faced demolition and condemnation without insurance settlement money, “[took] advantage of the socioeconomic conditions of residents and the inability of residents to raise the money to make the repairs.” In other words, the insurer is accused of delaying claim settlement to force a more advantageous settlement. The association has already won a $25 million lawsuit against the insurer in February, 2009.

The Risk and Insurance Management Society (RIMS) will be broadcasting a webinar entitled “ISO 31000 and Its Implications to Risk Management” on December 10, 2009 from 1:00-2:00pm ET. The cost is $30 to non-members and free to members of RIMS.

ISO 31000 is a generic set of guidelines applicable to risk management and it can be helpful to know when establishing your organization’s risk management policy.

RIMS will also be holding a CourseCast on December 10, 2009, from 1:00-2:30pm ET, entitled “Casualty Claim Handling Techniques:
Agency Law.” Details can be found at the RIMS website.

The Occupational Safety and Health Administration (OSHA) issued some holiday specific directives last week. Employers, especially retailers, should take note of the guidelines in time for their holiday preparations.

On November 17, OSHA issued crowd control guidelines designed to lower the risk of crowd related accidents. Last year a worker was trampled to death while a mob of shoppers rushed through the doors of a large store to take advantage of an after Thanksgiving Day “Black Friday” sales event. OSHA claims in its press release that the store “was not using the kind of crowd control measures recommended in OSHA’s fact sheet.” The Fact Sheet is available online.

I had a number of health insurers contact me to point out that they also have some form of kid/young adult friendly health education and awareness campaign after my post about Aetna’s yesterday.

The one that I missed, that everyone else seemed to know, was the DocRock series of videos offered by Cigna. Dr. Mache Seibel, a.k.a. DocRock, is a real doctor with the University of Massachusetts Medical Center. He has teamed with CIGNA to launch the H1N1 Rap video at www.youtube.com/cignatv. One video “raps” for kids about 5 tips to avoid Swine Flu.

Health insurer Aetna has taken an interesting, and entertaining, approach to increasing prevention awareness for the H1N1 virus infection. The insurer has created a video featuring kids talking about prevention.

The kid advice is great. “If you cough onto someone, they can get sick. So cough into a tissue. Then throw it into the garbage and wait for the garbage truck to come.” Or this reminder: “If you sneeze into your hands and then grab the remote to change the channel, there are germs on the remote.” Bill Fried, MD, Aetna’s medical director heading the company’s pandemic flu response initiative, states, “Kids listen to other kids. Adults should listen too. We’ve all heard the advice about washing your hands and covering your cough, but sometimes kids say it best. After all, who knows more about germs than kids?”