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Certified Insurance Fraud Investigator (CIFI) Information and Application

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CIFI Overview

The Certified Insurance Fraud Investigator (CIFI) program is an accrediting process for individuals with the specialized skills required to detect, investigate and deter insurance fraud. The program has a high standard for admission and testing which includes adherence to IASIU’s code of ethics, and a demonstrated competency through mandatory continuing professional education.

To be eligible for the examination, you must score a minimum number of points on the Education and Experience form included in this document.

Examination applications are accepted any time of the year. Tests will be given upon individual requests, and IASIU will find a proctor in your area to administer the examination. Periodically chapters will administer exams to a group; these exam dates will be posted to the IASIU website. The CIFI exam is administered each year at the Annual Seminar. If an IASIU chapter wishes to sponsor an exam, they must contact the IASIU office for approval at least 90 days prior to the test date.

Nonmembers of IASIU will be charged $400 to take the examination, and members of IASIU will be charged $200.

If you qualify for membership, your membership application and payment fees must be received and application approved prior to submitting your CIFI application in order to qualify for the lower member rate of $200.

Once an individual receives certification, they must be re-certified every three years. In order to qualify for re- certification, the individual must maintain the standards set forth in IASIU’s Code of Ethics and obtain 60 continuing education units (CEUs) over a three year period. A minimum of 10 credits per year must be obtained, which includes taking a one credit ethics course. For CEUs to qualify, they must relate to the investigation of insurance fraud, and a certificate of completion or other proof of attendance must be maintained by the CIFI and submitted to IASIU upon request.

Why become a certified insurance fraud investigator?

• It gives the individual professional recognition in their field.

• It adds to the individual’s qualifications needed for expert court testimony. • It can be used as an advertising/marketing tool for insurance company SIU’s. • It ensures consistent high standards throughout the industry.

• It provides highly qualified individuals to investigate suspected insurance fraud.

• It inspires public confidence in the integrity, objectivity and professionalism of insurance investigators. • It helps to build the individual’s resume.

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Point Guidelines for CIFI Certification Education

To receive points in this category, the applicant must have one or more of the following:  Bachelor’s Degree from an accredited college

 Master’s Degree from an accredited college  Ph.D., J.D. from an accredited college SIU Investigative Experience

To receive points in this category, the applicant must be or have been:

 An insurance company employee whose primary purpose is the investigation and/or supervision of investigation of insurance fraud, or

 An employee of a self-insured corporation or company whose primary purpose is the investigation and/or supervision of investigation of insurance fraud, or

 A special agent or supervisory special agent of the National Insurance Crime Bureau or the Insurance Crime Prevention Bureau, or

 A full time investigator for a state fraud bureau. Experience

 Law Enforcement Investigative Experience: To receive points in this category, the applicant must be, or have been a local, state or federal law enforcement officer and/or investigator; or a fire department investigator.

 Insurance Adjuster Experience: To receive points in this category, the applicant must be or have been:

o An insurance company employee whose primary purpose is the investigation and/or supervision of investigation of insurance claims, or

o A self-insured corporation company employee who is assigned to a claims handling unit and whose primary purpose is the investigation and/or supervision of investigation of insurance claims.

 Licensed Private Investigator: To receive points in this category, the applicant must be or have been a private investigator licensed by a state or local government agency.

Certifications

To receive points in this category, the applicant must have certification(s) from a professional organization concerned with the detection and/or prevention of fraud.

Other Experience

To receive points in this category, the applicant must have:

 Published a book on a subject directly related to the investigation of insurance fraud. Attach a list showing the title and publishers name for all books authored, and attach a copy of the copyright page with the Library of Congress catalog number.  Published a paper or article in a professional magazine or journal on a subject directly related to the investigation of insurance

fraud. Attach a list showing title and publisher’s name for all authored articles, and attach a copy of the article pages which show the magazine or journal name, date, article title and your name.

 Given lecture(s) at professional industry organization meetings, seminars or conferences on a subject directly related to the investigation of insurance fraud. Industry organizations are defined as: IASIU, IAAI, ACFE, IATTI, etc., national and chapter functions. Attach a list showing organization, topic, location and date of each lecture.

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Study Materials for CIFI Examination

The following is a list of resource materials for investigators who take the CIFI examination. It is difficult to list many as there is a scarcity of written materials to study. This is a test of knowledge and experience rather than a course of study.

Materials used to develop the exam include:

• Law of Claims Fraud Investigation and Defense, American Educational Institute

Property Investigation Checklists: Uncovering Insurance Fraud, 8th edition, Michael H. Boyer, West Group, 2002. • The North American Training Group online CIFI prep course which can be purchased for $200 at the following link:

http://iasiutraining.natgtraining.com/index.php/iasiu/cifi-ce-preperation-training/cifi-preparation-training.html.

Additional sources include periodicals such as The John Cooke Fraud Report, SIU Today, the Coalition Against Insurance Fraud’s Fraud Focus and Mealey Publications’ Insurance Fraud.

There will also be questions arising out of investigation matters and legal experience that do not come from a specific written source. Helpful Hints:

1. Read each question carefully.

2. It is likely that at least two answers will be similar. Take your time to select the best answer. 3. Be careful of absolute statements such as “always” or “never.” The law is rarely absolute.

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Commonly Asked Questions about Re-Certification

It is important to understand the re-certification process when initially applying to take the CIFI examination. Once an individual receives CIFI certification, the individual must be re-certified every three years in order to keep the CIFI designation.

In order to qualify for re- certification, the individual must maintain the standards set forth in IASIU’s Code of Ethics and obtain 60 continuing education units (CEUs) over a three year period. A minimum of 10 credits per a year must be obtained, which includes taking a one credit ethics course in the three-year period. For CEUs to qualify, they must relate to the investigation of insurance fraud, and a certificate of completion or other proof of attendance must be submitted for all CEUs claimed.

What is the cost to re-certify?

The cost for re-certification is $100 for members and $200 for nonmembers. What do I use to record my CEUs?

The CEU Report Form is available for download at www.iasiu.org or you may obtain one by emailing info@iasiu.org.

When do I need to submit the CEU Report form for re-certification?

Do not send the form in as you obtain your CEUs. The form should be submitted no more than 60 days prior to the expiration date of your CIFI designation. To find out your expiration date, add three years to the date you received your CIFI designation.

What if I don't get the CEU Report Form in on time?

You have a 60-day grace period after your CIFI designation expires for you to report your CEUs. If you still do not get your form in during the grace period, your CIFI designation will expire, and you will not be authorized to use the CIFI designation. You must then re-apply and take the CIFI examination again to regain the CIFI designation.

How do I obtain CEUs?

The CEUs must be obtained from any of these categories: fraud training units (FTUs), instructor training units (ITUs), author training units (ATUs) or self-study training units (STUs). All the CEUs must be related to the investigation of insurance fraud.

What are FTUs?

FTUs (fraud training units) are training hours which must be obtained in a classroom setting, which includes an instructor. Attendance must be required and recorded, and a certificate of completion or attendance must be issued. Training hours must be insurance fraud or insurance crime related. One CEU can be claimed for each hour of insurance fraud or insurance crime related training. A copy of the certificate of completion or attendance record (sign-in sheet) must be attached to the CEU form. There is no limit to the amount of CEUs that can be claimed in this category.

What are ITUs?

ITUs (instructor training units) are fraud related instruction that you complete. It must take place in a formalized classroom setting using a course outline where attendance is required and recorded. The time spent instructing a fraud related course can be claimed each time the class is instructed. One CEU can be claimed for each hour of instruction. A list showing the date, time, location, subjects taught, length of instruction and the number of attendees must be attached to the CEU form. A total of 15 CEUs can be claimed in this category over the three-year CIFI period.

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What are ATUs?

ATUs (author training units) include published fraud related articles, books and videos. The time spent preparing for any of the above is allowable. One CEU can be claimed for each hour of preparation. A total of 30 CEUs can be claimed in this category over the three-year CIFI period.

For published articles, a list must be attached to the CEU form showing the title and publisher's name, along with a copy of the article pages showing the magazine or journal's name, date, article title and your name. For published books, a list must be attached to the CEU form showing the title, publisher's name and a copy of the copyright page with the Library of Congress Catalog Number. For published videos, a list must be attached to the CEU form showing the title, length of video, and the name of the publisher or production company.

What are STUs?

STUs (self-study training units) are credits for obtaining a professional designation. A copy of the certificate granting professional designation must be attached to the CEU form. A total of 30 CEUs can be claimed in this category over the three-year CIFI period . How many CEUs do I need to be re-certified?

You need 60 CEUs over the three year period to be re-certified. Can I get my 60 hours all in one year?

No. You must get at least 10 CEUs each year with a grand total of 60 hours over the three year period. Do I need CEUs to be approved ahead of time?

No. Simply follow the guidelines for recording CEUs as set forth on the CEU Report Form and as described in this document.

If a chapter is sponsoring a seminar on the investigation of insurance fraud, should I send the seminar outline so the CEUs can be approved ahead of time?

No. Simply follow the guidelines for recording CEUs as set forth on the CEU Report Form and as described in this document.

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Complete the appropriate areas and score your education and experience qualifications. (You cannot claim for experience in more than one of the categories in any given year.) A minimum of 100 points is needed for the CIFI Examination Application. This form indicates whether you have the proper education and experience to take the exam.

Education

Award the appropriate points for each degree.  Bachelor’s Degree (20 points) _____  Master’s Degree (10 points) _____

 PhD. (10 points) _____

 J.D. (10 points) _____

Total Points Claimed _____ SIU Investigative Experience

Award 10 points for each full year of experience. A minimum of 30 points is required in this category for the examination application.

Number of Years _____ x (10 points) _____ Total Points Claimed _____ Experience

Award 5 points for each full year of experience in the areas. Concurrent experience in more than one area cannot be claimed.

 Law enforcement investigative experience Number of Years _____ x (5 points) _____  Insurance adjuster experience

Number of Years _____ x (5 points) _____  Private investigator experience

Number of Years _____ x (5 points) _____ Total Points Claimed _____

Other Experience

Award the appropriate points for each experience.  Published books (15 points per book) _____  Published articles (3 points per article) _____  Lectures (3 points per lecture) _____

Total Points Claimed _____ Certifications

Award 5 points for each professional certification. (CFE, CFEI, CFI, CPA, FCLA, etc.)

List all certifications claimed

_____________________________________________ # of Certifications _____ x (5 points) _____

Total Points Claimed _____ Grand Total

Total (Education) _____

Total (SIU Investigative Experience) _____

Total (Experience) _____

Total (Other Experience) _____

Total (Certifications) _____

Grand Total _____

A minimum of 100 points is required for approval of your certification application.

(Must be submitted with application)

Please complete the following and submit to:

IASIU, 11950 W. Lake Park Dr., Ste. 320, Milwaukee, WI 53224 (ph) 414.375.2992, (fx) 414.359.1671, info@iasiu.org

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Contact Information

Name ___________________________________________________________________________________ Employer ________________________________________________________________________________ Work Address_____________________________________________________________________________ City__________________________________State__________ Zip_______________Country_____________ Work Phone______________________________________ Work Fax________________________________ Work Email_______________________________________________________________________________ Desired Test Date__________________________________________________________________________ Test Location (Select from online list or indicate city with state)_______________________________________ Application Requirements

□ IASIU Member – Member # _________

($200 fee + 100 points minimum, including a minimum of 30 points from the SIU experience category.) □ Nonmember of IASIU

($400 fee + 100 points minimum, including a minimum of 30 points from the SIU experience category.) Authorization and Payment

I certify the information on the Personal Information Form and the Education and Experience Form is true and correct to the best of my knowledge, and I have never been convicted of a felony offense. Falsification of any information on these forms is grounds for denial or revocation of certification. If this application is accepted, I agree to abide by the Bylaws and Code of Ethics of the International

Association of Special Investigation Units. I agree the information I have provided on this application may be used to verify

employment, education, certification, experience and other experience as stated in the application. I hereby authorize the release to IASIU of all records regarding my attendance at the above referenced educational institutions or records confirming my employment at the aforementioned employer.

Signature______________________________________________ Date________________________________ □ I have enclosed a check made payable to IASIU for $___________.

□ Please charge my Visa , American Express, or MasterCard (circle one) in the amount of $___________. Account Number_________________________________Card Expiration____________ CSC #_______ Card Billing Name_____________________________________________________________________ Card Billing Address and Zip Code ________________________________________________________

(Must be submitted with Education and Experience form)

Please complete the following and submit to:

IASIU, 11950 W. Lake Park Dr., Ste. 320, Milwaukee, WI 53224 (ph) 414.375.2992, (fx) 414.359.1671, info@iasiu.org

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