Celeste Dodson Reflects on a Career of Leading the Fight Against Insurance Fraud

The Demotech Difference (TDD) had the opportunity to meet with Celeste Dodson, MBA, CPCU, FCLA, former president, International Association of Special Investigation Units, to secure her thoughts on a variety of issues shaping the insurance industry.

The Demotech Difference (TDD): Welcome, Celeste. Thank you for sharing your thoughts and expertise.

Celeste Dodson (CD): Thank you. I am glad to have the opportunity to meet with you.

TDD: Let’s jump right into this conversation. What was it that initially attracted you to the insurance industry?

CD: My interest in pursuing a career within the Special Investigations Unit.

TDD: Can you single out one or two individuals that you would describe as “mentors?”

CD: Bob Romer, former State Farm claims manager. He encouraged and coached me to be true to myself, be the best “me,” to develop and grow my knowledge, and not to be afraid to step out of my comfort zone. Bob was also stricken with multiple sclerosis. He taught me, through his own actions and attitude, to not allow life’s challenges to bring you down, but instead to fight to succeed and to live your best life no matter what challenges you may face.

TDD: You have a comprehensive background in insurance and have secured serious insurance credentials. What kept you in the insurance industry?

CD: I came to the insurance industry because of my interest in investigations. I received a degree in criminology from Florida State University with intentions to work in law enforcement. When I learned about the work of the Special Investigation Units I was intrigued. I came to the insurance industry because I wanted to work in the SIU. I stayed in the insurance industry and within the SIU because of the great work we do and the impact we have in the fight against insurance fraud.

TDD: You have earned the Chartered Property Casualty Underwriter (CPCU) designation as well as the Fraud Claim Law Associate (FCLA) designation. Would you share your thoughts on a situation where the course work was directly applicable to a special investigation or gave you insight that was instrumental in arriving at a conclusion?

CD: All of the training and designations I’ve obtained have helped grow my knowledge of insurance and the investigation of insurance fraud. Continually learning and growing in knowledge is important for all insurance professionals, including SIU professionals.

TDD: Over your career, how has the role of Special Investigation Units evolved?
CD: When I started in the SIU, much of the focus was on the investigations of auto and homeowner property claims (fires/thefts) and a majority were conducted in the field. Boots on the ground — interviewing individuals, conducting scene investigations, completing courthouse searches, and attending Examinations Under Oaths in person. Although the SIU still has a presence in the field, many SIU investigators conduct their entire investigations from their desk. The type of fraud investigated has also evolved over time. Although bad actors have always been submitting all types of fraudulent insurance claims, over the decades we have seen an increase in staged/caused auto claims including passenger stuffing, swoop and squats, and organized medical fraud. We’ve also seen an increase in life/health insurance fraud, and with the advancements in technology, fraudsters have become very well versed at committing identity fraud and creating synthetic identities.

TDD: You have been active in the Pennsylvania Auto Theft Prevention Authority, as well as the International Association of Special Investigation Units, and are the VP of the Global Insurance Fraud Summit. Prior to discussing your experience with those entities, share your thoughts on volunteering to serve in professional organizations.

CD: It’s important for each of us, as professionals and experts in our field, to share our knowledge and time for the betterment of the industry and our communities. We are stronger when we work together. And when you volunteer your time to any organization, you always receive more than you give.

TDD: As a leader at IASIU and PA Auto Theft Prevention Authority, share your thoughts on recruiting volunteers who have a significant level of commitment.

CD: It is more challenging to recruit volunteers than it has been in the past. I believe it’s because of two reasons: (1) Fewer insurance employees and less SIU presence in the field, and more carriers consolidating their offices across the countries into large “hub” offices. (2) More demands on SIU professionals. More fraud, higher case volume, and less time to commit to other priorities or interests.

TDD: Your responsibilities for SIU have spanned multiple lines of insurance and multiple states. Please provide some insights on how investigations of claims might vary by line of business.

CD: The investigation of an arson claim, staged auto accident, theft claims, multi-claims, and identity theft claims, for example, vary greatly. The differences are too many to list; however the similarities are clear. Each requires the investigator to determine the who, what, where, and how of the claim. Verifying the facts of loss, the damages, determining and confirming the parties to the loss, interviewing witnesses, and determining how the loss occurred. The tools of the SIU investigator have also evolved, and the utilization of technology is a key for a successful investigation.

TDD: How might investigations of claims vary by state?

CD: How claims are investigated does not necessarily vary by state, nor do the types of claims submitted, with the exception of areas where weather events are more prevalent.

TDD: You have built several teams to focus on special investigations. What were the attributes that you sought in SIU investigators?

CD: Curiosity, initiative, analytical, a team player, and self-motivated.

TDD: What might the initial training of SIU personnel include?

CD: It depends on the knowledge they initially bring to the job, but may include investigative training, interview techniques, understanding the insurance policy, and the utilization of technology.

TDD: No sector is immune from advances in technology. How has technology assisted SIU teams in their investigations?

CD: SIU investigators utilize technology to investigate their claims, verify damages, interview witnesses, and map connections.

TDD: How has technology adversely impacted SIU teams?

CD: That’s a loaded question. There is a lot of discussion occurring regarding the benefits and challenges with the use of AI in the investigation of claims, but I’m going to answer that question from another angle. We know the bad actors are utilizing technology to commit insurance fraud. They are getting better and faster at committing fraud every day. The SIU community has a responsibility to understand and learn how to utilize technology to effectively identify, investigate, and resist insurance fraud.

TDD: It is TDD’s understanding that you are retiring. How do you plan to spend your leisure time?

CD: Spending time with family, taking long walks/hikes, and traveling. But although I have retired from many of my responsibilities, I am still actively involved in and am vice president of the Global Insurance Fraud Summit.

TDD: How would you suggest that the insurance industry recruit capable, young people to this important sector?

CD: Start by educating young adults in the classroom. Find ways to get into colleges and share our knowledge and experiences. Get the students excited about a career within the SIU.

TDD: Thank you for sharing your thoughts and expertise with us. Final thoughts before the lightning round of personal preferences?

CD: Insurance fraud affects everyone, costing families up to an additional $1,000 in insurance premiums each year. The work of an SIU investigator to identify, investigate, and resist fraud is important and impactful. Insurance carriers must continue to invest in their SIUs, ensuring they have the staff and expertise needed to effectively investigate claims with indicators of potential fraud.

TDD: Here is the lightning round of personal preferences. There are no wrong answers!

• Favorite meal:
I love salads and tacos.
• Favorite snack:
Chocolate!
• Favorite movie:
“Gandhi.”
• A book you would recommend:
I love David Baldacci novels.
• Cat or dog person:
Definitely a dog person.
• Hobbies that you enjoy and will be pursuing:
Hiking, traveling, reading (with a glass of wine on my deck …), and volunteering.

TDD: Good luck to you, and thank you again for sharing your time and your thoughts with us today.