Founded in 2004 by David M. Bogan, CFE, CFS, FCLS, WCLS, CWCP, DMB Investigators is is private investigations firm dedicated to the fight against Insurance Fraud.

 

 

Our services include:

Sub-rosa

AOE/COE

Fraud Investigations

Documented Referral for Prosecution

Claims Assist Investigations

Back Ground Investigations

Person Locates

Asset Checks

Medical Clinic Inspections

Vehicle Re-inspections

Area Canvass

 

 

David M. Bogan, CFE, CFS, FCLS, WCLS, CWCP

 

Professional Experience

PC550 Holdings, Inc., President/CEO                                                                  

2008 to Present

PC550 Holdings, Inc. is a holding company which maintains either wholly-owned or majority shares of companies providing anti-fraud/claim services to the insurance industry. Companies include: 

 

·         DMB Private Investigators, President

As president of DMB Private Investigators, I conduct and oversee complex investigations of all personal and commercial insurance lines including, but not limited to, auto theft, bodily injury, body shop fraud, premium fraud, and provider fraud as related to bodily injury and workers' compensation. Services include in-person recorded statements; preparation of detailed reports; assistance in preparing and appearing at examinations under oath and depositions; completion and submission of State of California Department of Insurance Suspicious Claim forms (FD-1); preparation and submission of state mandated fraud plans, annual fraud reports, and responsive documentation to audits by the California Department of Insurance; and law enforcement and referrals for prosecution to district attorney offices. SIU training responsibilities include development and implementation of training criteria in accordance with mandated SIU guidelines. 

 

·         Bogan Fraud Consult, President

Bogan Fraud Consult provides claims and Special Investigations Unit compliance and best practices consultations. Services include internal auditing and training. 

 

·         Safeclaims, LLC, President

Designed, developed and launched an enterprise software product which assigns weighted values to various “red flag” indicators of possible insurance fraud. 

 

·         VIN Advanced Forensics and Technologies, Inc.

Forensic analysis firm conducting forensic lock examination, forensic vehicle security analyses, mechanical failure, fire cause and origin, and engine fluids analyses. 

 

·         Med Claims Analysis, Inc.

Med Claims Analysis specializes in medical record and bill review, as well as conducting catastrophic injury bill negotiation and PIP regulatory billing review and settlement.

 

CGI Insurance Business Services, Inc., SIU Senior Investigator                                         

2005 - 2009

Conduct and oversee complex investigations of all personal and commercial insurance lines including, but not limited to, auto-related theft; bodily injury; body shop claims fraud; premium fraud; and, provider fraud as related to bodily injury and workers' compensation claims. Conducted in-person recorded statements; provided assistance and appeared at examinations under oath and depositions; prepared detailed, timely reports, State of California Department of Insurance Suspicious Claims (FD-1) forms; and appropriate prosecution referrals. Preparation and submission of the State of California Department of Insurance mandated Fraud Plan and Annual Fraud Report; and preparation of documentation in response to State of California Department of Insurance Special Investigations Unit audits. Developed and maintained liaison with claims upper level management and staff; Department of Insurance Fraud Division and Department of Industrial Relations–Workers’ Compensation Division personnel, and law enforcement and professional organizations within the anti-fraud community. As CGI’s SIU Training Coordinator, I developed and implemented training criteria and plans in accordance with state-mandated SIU guidelines; provided ongoing education and fraud awareness training to both SIU personnel and integral anti-fraud personnel throughout the United States; and directed and maintained records of continuing education as required for maintenance of professional designations of SIU staff. 

 

HUB Enterprises, Inc., California State Manager                                                      

2002 to 2005

Responsible for product and business development and maintenance of existing accounts in California; headed company expansion into new market in California; developed, trained, and managed investigative staff; and was responsible for management of quality and timeliness of investigative services. I was also responsible for licensing and compliance issues with the California Department of Consumer Affairs, Bureau of Security and Investigative Services. Assigned account manager responsibilities in April 2004. Prior position: Regional Director of Investigations for Eastern United States, at which time I managed twenty-nine investigators in an eleven state region. 

 

Bogan Investigative Group, Owner/Operator, Houston, TX                                     

1998 to 2002

Directed private investigation firm servicing the insurance industry; performed all outside sales and new business development; maintained existing client relationships with ongoing account service; managed field investigators serving the Central and Eastern Texas region; and conducted numerous complex investigations involving various fraud schemes.

 

John Bullock & Associates, Inc., Houston Branch Manager, Dallas, TX                 1996 to 1998

Managed field investigators conducting sub rosa, AOE/COE investigations; responsible for the timely and accurate reporting of the findings of investigations; new business development, outside sales and maintenance of existing accounts and client relationships; and budget management and cost analyses. 

 

Monarch Investigations, Inc., Investigator, Lewisville, TX                                        

1994 to 1996

Areas of responsibility included sub rosa, AOE/COE and criminal defense investigations, as well as automobile accident reconstruction. 

 

Corpus Christi Police Department, Police Sergeant/Detective                                1980 to 1993

·         Patrol Officer, twelve months

·         Vice–Squad

·         Narcotics, one year

·         Major Offenders Directed Enforcement, two years

·         Narcotics–Major Offenders Task Force, five years

·         Training Officer, one year

·         Criminal Investigation–Theft/Fraud, two years

·         SWAT, five years

·         Dive Master-Underwater Search and Recovery Dive Team, eight years

 

United States Department of Interior,

Payroll Fraud Investigator                           

1978 to 1981
Denver Federal Center, Denver, CO

 

 

Education

Mira Costa College, San Marcos, CA; Marketing                                                                      2005

Northwestern University, Evanston, IL; Vehicle Dynamics, Motor Vehicle                               1993

      Accident Reconstruction, Advanced Motor Vehicle Accident Reconstruction

Del Mar College, Corpus Christi, TX; Business Administration                                     1981 to 1993

Metropolitan State College, Denver, CO; B.S. Degree, Criminal Justice                     1978 to 1981

 

Professional Training Received

 

Workers’ Compensation Origin and Development, American Educational Institute, 2008

NICB–Current Fraud Trends and Resolutions, 2007

Certified Workers' Compensation Professional Conference, Michigan State University, 2007

Advanced Legal Issues; Bad Faith; The Policy and Its Requirements; Special Investigation; Proving Fraud; Recognizing Fraud; and, Common Law and the Courts, American
Educational Institute, 2007

Association of Certified Fraud Examiners’ Test Prep Course, 2007

Northern California Fraud Investigators’ Association, Annual Training Conference, 2006

Southern California Fraud Investigators’ Association, Annual Training Conference, 2006

Innovations in Interviewing Auditing for Non-Auditors, e-Fraud, Medicare Fraud Investigation and Elder Abuse, Association of Certified Fraud Specialists’ National Conference, 2005

IASIU National Conference, 2005

Body Shop Fraud, Western States Auto Theft Investigators’ Association, 2005

Northern California Fraud Investigators’ Association, Annual Training Conference, 2005

Southern California Fraud Investigators’ Association, Annual Training Conference, 2005

Fraud Examinations, Association of Certified Fraud Examiners, 2005

Investigating e-Fraud, Association of Certified Fraud Examiners, 2005

Interviewing for the Fraud Examiner, Association of Certified Fraud Examiners, 2005

Auto Theft Investigations; Property Claims Investigations; Body Shop Fraud Investigations;
and Workers' Compensation Fraud Investigations, National Insurance Crime Training Administration, 2005

 

 

 

Professional Designations

·   CFE:  Certified Fraud Examiner, Association of Certified Fraud Examiners

·   CFS:  Certified Fraud Specialist, Association of Certified Fraud Examiners

·   CWCP:  Certified Workers' Compensation Professional, Michigan State University, School of Labor Relations, Ambassador, Employers’ Fraud Taskforce

·   FCLS:  Fraud Claim Law Specialist, American Educational Institute

·   WCLS:  Workers' Compensation Law Specialist, American Educational Institute

·   WCLA:  Workers' Compensation Law Specialist, American Educational Institute

 

Licenses

California Private Investigator, License Number 24331

California Private Investigator, License Number 26534

Texas Private Investigator, License Number A09279

California Locksmith, License Number 4455

 

 

Publications and Presentations

Publications

 

“Is the Economy Driving Insurance Fraud,” The Adjuster, SDIAA newsletter, August 2009.  (An examination of trends regarding bodily injury and owner give-up claims.) 

 

“Crackdown: Your Guide to Insurance Fraud Detection and Prevention,” Claims Magazine, December 2008.  (Workers’ compensation premium fraud, thwarting pervasive schemes.)

 

“Claims Management: Stop Fraud, Avoid Loss,” Employers’ Fraud Taskforce training video, chief technical advisor, October 2008. 

 

 

Training Presentations

 

Red Flags of Fraud/CA SIU Regulations/Trends and Emerging Technologies within Lock Forensics, Blackhawk Claims Services, Inc., October 2009

Identifying Red Flags of Fraud During the Appraisal Process, Inland Valley Appraisals, February 2009

California SIU Regulations, State National Insurance, January 2009 and December 2008

Red Flags of Casualty Fraud/California SIU Regulations, TCS-One, February 2008

Red Flags of Nomadic Group Fraud/California SIU Regulations, State National Insurance, February 2008

Red Flags of Casualty Fraud/California SIU Regulations, Coronado Insurance Whole Services, February 2008

Red Flags of Casualty Fraud/California SIU Regulations, Union Labor Life Company, February 2008

Workers’ Compensation Premium Fraud, American All-Risk Loss Administrators,     January 2008

Workers' Compensation Fraud/California SIU Regulations, Union Labor Life Insurance Company, November 2007

Workers' Compensation Fraud/California SIU Regulations, Web-Ex, Union Labor Life Insurance Company, Chino, November 2007

Workers' Compensation Fraud/California SIU Regulations, Web-Ex, Asurion Insurance Services, October 2007

Workers' Compensation Fraud/California SIU Regulations, Frontier General/Wellington Financial Services, Inc., October 2007

Workers' Compensation Fraud/California SIU Regulations, Web-Ex, First Mercury Insurance, October 2007

Workers' Compensation Fraud/California SIU Regulations, Alliant Services Houston, Inc., August 2007

Workers' Compensation Fraud/California SIU Regulations, Universal American Financial Corp., October 2007

Material Misrepresentation within the Insurance Policy and Claims Process, Association of Certified Fraud Specialists National Conference, San Diego, CA, August 2007

Healthcare Fraud/California SIU Regulations, Union Labor Life Insurance Company, Zenith Administrators, San Francisco, CA, July 2007

Healthcare Fraud/California SIU Regulations, Union Labor Life Insurance Company ATPA, Concord, CA, July 2007

Healthcare Fraud/California SIU Regulations, Union Labor Life Insurance Company, Professional Insurance Consultants, Concord, CA, July 2007

New Hire Training, State National Insurance, Arlington, TX, July 2007

New Hire Training, American All-Risk Loss Administrators, Fresno, CA, July 2007

Annual Fraud Awareness Training, Tidewater Claims Services, Inc., San Diego, CA, April 2007

Annual Fraud Awareness Training, AMCON Claims, Inc., San Ramon, CA, April 2007

Successful Interviewing, Association of Certified Fraud Specialists National Conference, San Francisco, CA, September 2006

SIU Regulations, Red Flags, Reporting and Fraud Awareness as Related to Auto Theft Fraud, Blackhawk Claims Services, San Diego, CA, June 2006

Auto Theft Fraud Awareness, Red Flags, and Interview and Statement Techniques, Platinum Claims Services, Camarillo, CA, February 2006

Low Impact Crash Assessment and Staged Accident Fraud Awareness, TIG/Clarendon National Insurance, Colorado Springs, CO, August 2005

Low Impact Crash Assessment and Staged Accident Fraud Awareness, TIG/Clarendon National Insurance, Las Vegas, NV, May 2005

 

Professional Organization Memberships

California Department of Insurance, Fraud Consortium

Association of Certified Fraud Examiners

Association of Certified Fraud Specialists, Vice Present, City of Angels chapter

International Association of Property Crimes Investigators

International Association of Special Investigative Units

Southern California Fraud Investigators’ Association

Northern California Fraud Investigators’ Association

Western States Auto Theft Investigators’ Association

Fraternal Order of Police, Texas Regional Lodge 27, past president

Emerald Society

Friendly Sons of St. Patrick

Mark Todd Hale Memorial Scholarship Fund, founding president

Women’s Shelter of the Coastal Bend, Corpus Christi, Texas, board member

 

Taskforce Participation

·   FBI, Fraud Initiative, San Diego, CA

·   Auto Theft Roundtable, San Diego District Attorney’s Office, San Diego, CA

·   Premium Fraud Task Force, San Diego District Attorney’s Office, San Diego, CA

·   Insurance Service Provider, Tax Evasion and Billing Fraud Task Force, Los Angeles District Attorney’s Office, Los Angeles, CA

·   California Department of Insurance Fraud Consortium, Department of Insurance, Fraud Division, Rancho Cucamonga, CA

·   Employers’ Fraud Task Force, Anaheim Hills, CA

 

 

Awards and Recognition

Fraud Fighter Award, Employers’ Fraud Task Force, February 26, 2008, (for contribution to the workers’ compensation anti-fraud effort). 

 

Fraud Fighter Award, Employers’ Fraud Task Force, January 11, 2010, (for contribution to the workers’ compensation anti-fraud effort). 

 

 

Expert Testimony

Blackman v. Johnson, et al., case number District Court, County of Las Animas, State of Colorado, automobile accident injury case. Provided testimony regarding impact velocity utilizing crush, force vectoring, and coefficient of friction calculations to determine impact velocity. 

 

Zapanti v. Pacific Railroad Contractors, Inc., et al., case number 86 CV 72, District Court, county of Las Animas, State of Colorado, RICO case. Analysis and subsequent testimony regarding the investigation, audit procedures, and findings as related to the organizational misappropriation and embezzlement of railroad workers’ retirement funds. 

 

Richard Penek v. Cheesecake Factory, et al., case number LBO 0316807, State of California, Department of Industrial Relations, Division of Workers’ Compensation, Workers' Compensation Appeals Board, Pasadena, CA. Provided testimony regarding material misrepresentations made and whether the investigative techniques employed were within generally accepted investigative techniques and procedures.