Identity Resolution Daily

January 30th, 2009

[Post from Infoglide] Will Workers Comp Employer Fraud Keep Rising?

“In our collections of links about identity resolution, we often include stories about employees who defraud workers compensation agencies. Most of the time it concerns someone who’s claimed a disability in order to get payments and is then working another job that proves they are healthy.  Another twist is covering up the fact that a relative drawing workers comp benefits has died in order to continue receiving payments.”

Insurance & Financial Advisor: Pennsylvania man among seven charged in multi-million dollar workers’ comp fraud

“In a pair of recent indictments, the defendants are accused of lying on insurance applications and failing to remit insurance premiums to the insurance companies, instead keeping the money for themselves, according to theNew Jersey Attorney General’s Office. The defendants are also accused of laundering money so the scheme would go undetected. As a result, many people were allegedly left without workers compensation insurance.”

Business Intelligence News: Gartner’s Magic Quadrant for Business Intelligence Platforms 2009

“Recently, Gartner published its report called Magic Quadrant for Business Intelligence Platforms 2009. This report is Gartner’s opinion about the market of BI and their main vendors.”

Network World: MySpace faces fresh controversy over sex offender issue

“Pallorium maintains a database of more than 600,000 sex offenders culled from state registries around the country. Rambam said he took a random sample of 40,000 names from that database and then searched more than 2 million MySpace member pages for matches. An initial search using first and last names, approximate age and city and state of residence as keywords yielded over 12,400 matches, Rambam claimed.”

Daily Insurer: New Yorker Nabbed in Workers’ Comp Scheme

“According to Solomon Jones, an investigator with the Insurance Department’s Frauds Bureau, Cossio submitted signed statements to the Insurance Fund falsely claiming he was unable to work after injuring his back while employed as a laborer. Jones said investigators found that Cossio was working as a porter and maintenance attendant while collecting the benefits.”

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By Robert Barker, Infoglide Senior Vice President & Chief Marketing Officer

In our collections of links about identity resolution, we often include stories about employees who defraud workers compensation agencies. Most of the time it concerns someone who’s claimed a disability in order to get payments and is then working another job that proves they are healthy.  Another twist is covering up the fact that a relative drawing workers comp benefits has died in order to continue receiving payments.

The Ohio Bureau of Workers’ Compensation estimates that they pay as much as $320 million annually in fraudulent claims to both employees and employers. Their definition of fraud is “as an intentional act or series of acts resulting in payments or benefits to a person or entity that is not entitled to receive those payments or benefits. Fraud is committed when a person
•    knowingly receives benefits which he or she is not entitled to receive by law;
•    makes false or misleading statements for the purpose of receiving money or services; or
•    enters into a conspiracy to defraud the Ohio State Insurance Fund or self-insuring employer under the Workers’ Compensation Act.”

While the employee fraud problem is significant, blogger Leonard Jernigan rightly points out that the third type of fraud in Ohio’s definition, i.e. fraud by employers, is an even bigger problem. “When thousands of employers across the country intentionally fail to pay required workers’ compensation premiums or misrepresent the job classification of employees who are covered, the fraud perpetrated on the system vastly exceeds the dollar amount of employee fraud.” Despite this fact, attention (and most of the news coverage) seems to be focused on employee fraud. Perhaps it’s the “gotcha” aspect of many of the nighttime news programs that makes employee fraud more appealing. Employer fraud isn’t as sensational but, based, on the financial impact, it should be getting more attention.

Jernigan lists no fewer than 14 different ways that employers defraud the system and thereby increase the burden on taxpayers for underwriting the healthcare costs of injured workers. Employer fraud takes many forms, but in all cases the object is to eliminate or reduce payments into the workers compensation system, and that increases the tax burden on all of us. The current challenging economic situation will likely increase the temptation for businesses to workers compensation payments. The losses incurred through employer fraud should increase detection and prosecution efforts.

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By the Infoglide Team

Sacramento Bee: Worker’s comp fraud brings prison, $144,000 restitution

“Federal prosecutors said that Abdullah’s father received about $2,500 a month in worker’s compensation benefits from the Labor Department under the Federal Employees Compensation Act. His father died of lung cancer on Nov. 18, 1999. Following the death, Abdullah completed three separate Labor Department forms where he forged his father’s signature in order to continue receiving benefits.”

Gartner: Where did MDM “come from” in the first place?

“Correctly, in my view, Chimni affirms that MDM had common roots in two different parts of the business: how to achieve single view of product, and customer.  And when we say, ’single view’, we don’t really mean that.  We mean, ‘from a single source of master data, each user in context to the task at hand, can perceive the information in the way they need too’ which really results in multiple views from one source.  But we say colloquially, ’single view’ as its simpler.”

Lottery Post: Store owners, clerks accused of stealing winning tickets

“They told the officer the ticket was worthless, then kept it and claimed the winnings themselves. ‘Sometimes the tickets might be confusing to some people or they are might be in a hurry. They are trusting the person behind the counter is going to tell them the proper amount,’ said Bill Hertogue with the California Lottery.”

Andy on Enterprise Software: Running Against the Tide

“One interesting aspect of this is that the MDM software market so far appears to be holding up well. Indeed it is currently growing at an annualised rate of 30% according to our research,a healthy clip.”

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[Post from Infoglide] Free Information Flow

“The introduction of free flowing information open to all in the form of a blog is a great way to communicate and share information and ideas.  I especially appreciate the opportunity to push ideas and concepts around in an open forum, in agreement or disagreement.”

[Post from Infoglide] Are You Serious?

“We received a comment on our recent post that contrasted identity resolution with data matching that I can’t let go unanswered. Here’s what the respondent said…”

Hub Solution Designs: MDM and SOA, a Strong Partnership

“Let’s not allow Master Data Management (MDM) to become just another silo of data!  MDM and Service-Oriented Architecture (SOA) together, create a strong partnership in your enterprise architecture.”

Daily Record: Boonton cop admits false claim of job injury, resigns

“Hagen is a Gulf War veteran who also worked for police departments in Edison and Point Pleasant. In February 2007, he filed a worker’s compensation claim for a knee injury that he purported to sustain on Oct. 27, 2006, by slipping off a curb while on patrol that day. In reality, he admitted in court Friday, he hurt his knee while playing a pick-up basketball game at the Mountain Lakes YMCA.”

The Eagle-Tribune: Sisters charged with fraud in fake crash

“Lopez, a former van driver and chiropractic assistant for Kaplan Chiropractic Corp. on Sutton Street in North Andover, is considered the mastermind of at least a dozen accidents being probed by the task force, according to investigators. Clinic operator Michael Kaplan, of Hampstead, N.H., was indicted with Lopez several months ago by a special grand jury probe initiated by the state attorney general’s office.”

B-Eye Network: Gartner Reveals Five Business Intelligence Predictions

“By 2010, 20% of organizations will have an industry-specific analytic application delivered via software as a service (SaaS) as a standard component of their BI portfolio. Information aggregators will increasingly rely on SaaS to deliver domain specific analytic applications built from industry data they collect and shift the balance of power in the BI platform market in their favour.”

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By Mike Shultz, Infoglide Software CEO

The introduction of free flowing information open to all in the form of a blog is a great way to communicate and share information and ideas.  I especially appreciate the opportunity to push ideas and concepts around in an open forum, in agreement or disagreement.

Doug Wood clearly scratched a sore spot with his post of January 13, “Does Data Matching Qualify as Identity Resolution?”.  Dan Power of Hub Solution Designs, a sometimes guest writer on Identity Resolution Daily, chimed in with his thoughts on how and when identity resolution fits into the MDM world. Then Tom Allen posted a spirited response that put forth his thoughts on the subject of Identity Resolution that elicited a strong response on January 21 from Bob Barker.

No single person’s position is as important as their collective opportunity to openly communicate their ideas and to debate the issues.  I’m delighted that Identity Resolution Daily is the place on the web to host some of the leading thoughts from some of the best thinkers on the complex subject of identity and entity resolution.  Infoglide Software is committed to remaining the leader in this exciting technology, and we really appreciate the interest.

Thanks for joining in.

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By Robert Barker, Infoglide Senior Vice President & Chief Marketing Officer

We received a comment on our recent post that contrasted identity resolution with data matching that I can’t let go unanswered. Here’s what the respondent said:

“Interesting.  So what Identity Resolution consists of is a bunch of data standardization tables and a matching tool?  Seems like a name equivalence table and a color equivalence table and any of the off the shelf matching tools would solve your problem.  That is a pretty trivial solution to a pretty complicated problem.  Thanks for [sic] you insight.”

Wow, talk about missing the point! Data matching products are clearly useful for certain types of problems, e.g. cleansing data before insertion into a data warehouse. What we stated is that whole classes of problems demand a different approach, and the current tendency to re-brand data quality products as “identity resolution” is misleading. Here’s why.

First, identity resolution is far more than a name equivalence table and a color equivalence table. There is no such thing as a passport equivalence table. The technology has to “understand” the standard formats for passports from many different countries and also understand the possible ways those passport numbers may be manipulated. Also, an equivalence table and COTS matching tools wouldn’t be able to determine that two homes are right next to each other even though they have totally different street names.

Additionally, a robust identity resolution technology needs to be able to search and analyze free text and compare different elements in an unstructured blob of text to find similarities. Those are just a few examples of the types of data comparisons that can be accomplished with identity resolution. Our Identity Resolution Engine™, for example, uses over 50 domain-specific Similarity Search algorithms, each with its own intellectual property, to compare many different types of attributes.

Second, data matching tools typically reduce the amount of available data by combining “like” entities. The goal is “de-duping” and standardization of the data. Typical responses are simply “yes it’s a match” or “no it’s not a match.”  While fine for basic MDM and data warehousing efforts, it’s not so great for mission-critical applications, or if you’re trying to retain the data for future analysis. Losing data is not an option – the diversity of the data contains valuable forensic information about how (id)entities are matched or linked as relationships.

With ten years of R&D, we’ve perfected the combination of lexigraphic algorithms with over 50 domain-specific algorithms to deliver a high degree of precision which precludes false positives – something that can’t be approached using a single generic equation.  For example, DHS’s Secure Flight program required true identity resolution, and that’s why we won that business over hundreds of others.

And finally, a comprehensive identity resolution technology, in addition to data matching, should have the ability to:
•    Uncover non-obvious relationships between seemingly disparate identities/entities,
•    Apply rules and decisioning based on the specific industry, application, and organization,
•    And integrate that knowledge back into existing business applications.

If you’re seriously interested about educating yourself on how identity resolution differs from data matching, we’ve written extensively about the subject. Check out posts in early December, then a week later, then once more right before the holidays.

If you’re not serious about identity resolution, then I’m not sure why you’re reading this! If you ARE serious, we’d like to hear your thoughts.

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[Post from Infoglide] Does Data Matching Qualify as Identity Resolution?

“Any true identity resolution engine must not consist simply of a mathematical matching equation, nor must it rely upon data-deterioration processes such as ETL and data warehousing. Math cannot tell a user that Ian is an acceptable nickname for John, nor can simple mathematical equations point to similarities between the colors grey and charcoal.”

Fiscal Policy Institute: Building Up New York, Tearing Down Job Quality

“As buildings go up in New York City, more and more construction work has gone underground, signifying violation of several employment and tax laws. An estimated 50,000 New York City construction workers—nearly one in four—are either misclassified as independent contractors or employed by construction contractors completely off the books.”

SearchDataManagement: Enterprise-wide customer data quality still elusive at most organizations

“So why do so few organizations use data quality tools for customer data enterprise-wide? The reason, according to some, is that most companies collect and store customer data in numerous data sources spread throughout the organization with no way to connect them. Put another way, lacking a single view of the customer through a master data management (MDM) system or customer data integration (CDI) initiative, organizations lack any realistic way of applying data quality tools enterprise-wide.”

WorkersCompensation.com: Rome Man Accused Of Double Dipping

“A 58-year-old Rome man discovered working after he claimed a job-related injury prevented him from doing so was arrested Thursday on charges that he fraudulently collected $17,940 in workers’ compensation benefits.”

Multichannel Merchant: Retail Crime Up Thanks to Down Economy

“According to the National Retail Federation’s 2008 Returns Fraud Survey, released in November, retailers will see a total of about $219 billion in returns from sales made in 2008 – a 19% increase over the $178 billion in returns recorded in 2007. Of those returns, about $11.8 billion will be fraudulent – an increase of about 8% over last year’s figure of $10.9 billion.”

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By Douglas Wood, Infoglide Senior Vice President

Identity Resolution and Entity Analytics are names given to advanced operational business intelligence tools that allow organizations to glide across disparate – possibly remote – sources of data, with a view to understanding possible matches and non-obvious relationships across that data.  In order to accomplish this feat, an identity resolution engine must utilize attribute-specific matching algorithms that take into account variances in structures and spellings of different attributes, AND have the capabilities to point to subtle relationships or clusters within those data sources.

Any true identity resolution engine must not consist simply of a mathematical matching equation, nor must it rely upon data-deterioration processes such as ETL and data warehousing. Math cannot tell a user that Ian is an acceptable nickname for John, nor can simple mathematical equations point to similarities between the colors grey and charcoal.  Only an identity resolution engine – not a generic matching tool – has the capabilities required for mission-critical functionality within the enterprise.

Entity analytics tools that require movement and/or cleansing of data are equally ineffective.  Once attributes are moved, modified or mitigated, the forensic value is lost forever.  True identity resolution engines never destroy data, nor do they assume one equation solves all matching problems.

As a leader in the development and deployment of identity resolution and entity analytics software, we at Infoglide have begun to see an interesting repositioning of simple data-matching tools as “identity resolution” software.  While we welcome the growth of our industry with open arms, it’s important to understand the differences between a matching tool versus a robust identity resolution engine for entity analytics and non-obvious relationship analysis.

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By the Infoglide Team

WorkersCompensation.com: Seven People And 11 Corporations Charged In Million-Dollar Workers’ Compensation Fraud

“The indictment alleges that as a result of the misrepresentations, the defendants committed insurance fraud by avoiding payment of $304,244 in workers’ compensation insurance premiums… Eight corporations were charged in the second indictment: Sciarra Insurance Agency; AJAX Enterprises, a.k.a. AJAX Leasing, Inc.; AJEX Enterprises, Inc., UJEX Enterprises; Inc., Q-Town, Inc.; and Homestead Assurance Brokerage, all formerly located in Audubon, as well as America’s PEO, Inc., a.k.a. America’s PEO Holdings, Inc., a.k.a. Staff America, formerly of Cherry Hill; and PTD Financial, Ltd., formerly of Mt. Laurel.”

Wall Street Journal: Should Private Jet Fliers Have to Suffer Security Checks?

“The Department of Homeland Security has proposed background checks on pilots and checking passenger names against terrorist watch lists.”

Daily Record: DLLR seeks stronger contractor guidelines

“‘This robs the state of tens of millions of dollars in workers’ compensation and unemployment insurance,’ he said. ‘This also deprives employees of the benefits that they are entitled to under law.’”

Hub Solution Designs: 2009 Predictions

“Certainly, companies that were just “testing the waters” on MDM may cancel or slow down their initiatives, and anyone making the front pages or the nightly news (and not in a good way) is probably going to see some disruption to their Master Data Management efforts. But I’ve been pleasantly surprised by how much interest and activity we’ve seen, particularly since 2009 started.”

North Country Gazette: State Puts Brakes On Trucker’s Benefits

“Tornatore now faces charges of insurance fraud, perjury, offering a false instrument for filing and fraudulent practices, all felonies. The estimated potential savings in this case is $257,654.”

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[Post from Infoglide] Critical Requirements for Identity Resolution

“Products in adjacent spaces like MDM and data quality often address a small subset of these requirements, but the number of integrated offerings that address all of them is a very, very short list!”

Travel Management: Secure Flight Implementation Begins

“Secure Flight will be implemented in two phases, first for domestic flights and then, “in late 2009,” for international flights. U.S. Customs and Border Protection, not the airlines, thus far has been responsible for the international watch list-matching function.”

Workers’ Compensation Law Center: Suspects Charged With Conspiracy to Defraud California’s State Compensation Insurance Fund of $18 Million

“‘I will not stand for scam artists taking advantage of the system,’ said Commissioner Poizner.  ‘The Department of Insurance will continue to track down and help prosecute anyone who seeks to defraud insurance companies or consumers.’ Zahler and Tai allegedly conspired to defraud the State Fund of over $18 million in insurance premiums they owed for the workers’ compensation policy issued to Staffing Services, Inc., a temporary employment company with thousands of employees.  It is alleged that the men purposely misrepresented the types of employees for which they obtained workers comp coverage, in order to pay $18 million less in premium payments.

Evolution of Security: TSA on 60 Minutes

“Ms. Stahl had access to the TSA Operations Center, also known as the Freedom Center. This is our main information center, where analysts monitor the entire transportation network and connect TSA with the Department of Homeland Security, Federal Aviation Administration, FBI, and other law enforcement and security agencies. It is the kind of place you would hope exists in the post 9/11 world.”

NYSIF: Central New York Trucker Charged With Workers’ Comp. Fraud

“Mr. Tornatore now faces charges of insurance fraud, perjury, offering a false instrument for filing and fraudulent practices, all felonies. The estimated potential savings in this case is $257,654. Along with NYSIF’s Division of Confidential Investigations, the Insurance Department’s Insurance Frauds Bureau and the Office of the Inspector General of the Workers’ Compensation Board participated in the investigation.”

7th Space Interactive: DHS End-of-Year Accomplishments

“During 2008, TSA worked tirelessly to begin implementing the Secure Flight program by early 2009, under which it will assume watch list checks from airlines to help create a more consistent passenger screening process and reduce the number of misidentifications.”

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