Check-in and pick up your badge

Connect with fellow attendees on a guided walking tour of downtown Calgary.

Thank you for signing up - all spots are full. If you registered, please pick up your badge before the walk. 

A Speaker Ready Desk is where speakers can check in with staff, review slides, and ask questions related to their presentation.

Welcome to Calgary and the CLHIA's Claims and Anti-Fraud Conference! Join us at our opening general session hosted by our Conference Chair, Joanne Wedgewood from Alberta Blue Cross.

CLHIA Update: Partnering for Better Health: How Private Life and Health Insurers are Supporting Canada’s Healthcare Landscape
Hear an update from the CLHIA on key policy files and priorities for the industry.   
Speakers:

• Joanne Bradley, VP Anti-Fraud, CLHIA 
• Joan Weir, VP Group Benefits, CLHIA 

Keynote: Fire Up Your Mental Health presented by Anthony McLean

This keynote presentation is sponsored by: Canadian Chiropractic Association

Track: Health

Gain insight into the unique contributions and expertise of a podiatrist, a pedorthist, and an orthotist in this informative panel discussion.

Our experts will delve into their shared role in managing chronic conditions like diabetes, highlighting the critical importance of foot care in improving patient outcomes. Through this discussion, attendees will gain a deeper understanding of each profession’s value to the healthcare team and how they work together to enhance patient well-being.

Track: Health

Private workplace drug benefits pay $14.3 billion in claims annually – about one-third of all outpatient prescription spending in Canada. As the federal government rolls out the first-wave of national pharmacare formularies, insurers must be able to quantify and communicate how private plans complement, rather than duplicate, public coverage.

Track: Disability, Life & CI

In this session, we will explore how two transformative treatment classes – microdosing psychedelics and GLP-1 receptor agonists – are poised to reshape the landscape of insurance claims, particularly in Life, Disability Income (DI), and Critical Illness (CI). Building on over 25 years of research, microdosing psychedelics is emerging as a promising alternative for mental health conditions like depression, anxiety and PTSD, offering neuroplastic benefits with fewer risks than traditional treatments. Since the approval of Prozac (fluoxetine) in 1987, antidepressant options have evolved, with psychedelics offering a groundbreaking shift in effectiveness and safety. Meanwhile, GLP-1 drugs are revolutionizing the treatment of metabolic conditions such as diabetes, obesity, and fatty liver with the potential to reduce excess mortality and reverse claims trends. From a medical director’s perspective, we’ll discuss how these innovations could improve patient outcomes and fundamentally alter the trajectory of insurance claims related to critical illness, disability, and premature death.

Track: Disability, Health, Life, CI

This panel discussion will discuss what the life & health insurance industry is doing to help reduce the administrative burden on the Canadian healthcare system and what more can be done using technology.

Track: Anti-Fraud

Fraud is ever changing and adapting, and so too should your Anti-Fraud Program. Organizations must ensure they can stay abreast of new and evolving fraud trends. But how do you assess your program, know where you’re at, how you’re doing and understand where and how you might improve?
This session will discuss industry standards and global best practices and frameworks for Anti-Fraud Programs. We will look at typical paths organizations take as they grow, mature and improve their Anti-Fraud programs. The session will cover:
-The importance of iterative Fraud Risk Assessments
-Growth, change, alignment and performance of controls to combat Fraud
-Areas to use data and analytics to measure improvements

Track: All

For decades, insurance professionals, claims analysts and investigators alike have had to discern fact from fiction. As we enter a new era with the rapid advancement of Artificial Intelligence (AI), our task is even more difficult. In a world full of synthetic accounts, fake news, and questionable resources, we now need to also navigate the world of AI. Images, resumes, documents, background information and even full identities can be created in an instant utilizing AI. The session will explore the various platforms currently available in AI and explore what can or cannot be done to identify the legitimate information from fake, manipulated or fabricated resources and evidence.

Help us kick off the conference and the opening of the Exhibit Hall. Visit with over 40 companies and associations with expertise or experience in a variety of different disciplines, from healthcare consulting and software to audit and investigations—plus much more. Remember to collect points with each exhibitor for the Conference Challenge and enter into a booth draw with participating companies.

Welcome Reception is sponsored by Gold sponsors

A Speaker Ready Desk is where speakers can check in with staff, review slides, and ask questions related to their presentation.

Check-in and pick up your badge

Enjoy breakfast while attending a Sunrise Talk. See the agenda for session room allocations. 

Seating is also available in Imperial 5. 

Join Dr. Ayla Azad for an insightful session exploring how proactive workplace wellness initiatives can drive better health outcomes and improve employee engagement. This session will delve into the critical connection between early intervention strategies—particularly for musculoskeletal (MSK) and mental health concerns—and overall organizational wellbeing. With a focus on practical, evidence-informed solutions, Dr. Azad will explore how comprehensive paramedical benefits can support a healthier, more resilient workforce. 

 A look at the rehabilitation pathway following the journey of a diabetic patient who uses both orthotic and prosthetic devices. Our panelists will explore how Orthotics, Prosthetics and related healthcare professionals work together to deliver positive mobility outcomes for patients.

As the pressure to realize the potential of artificial intelligence increases, it's important to ask: is AI always the answer? That depends on the problem and the data. This session will explore the capabilities of AI and the analytics continuum through practical and potential use cases in fraud and risk management.

Gain a better understanding of Athletic Therapy and its practical application in helping individuals return to work, play, and regular activities. This session will outline the scope of practice for Athletic Therapists and how their expertise contributes to patient recovery and functional restoration – with a strong focus on getting people back to full function as quickly and safely as possible.  We will also examine the Canadian Athletic Therapists Association (CATA) role in ensuring professional competency through education, training, and ethical oversight and discuss the current state of insurance coverage for Athletic Therapy in Canada.  

Certified Athletic Therapists (CAT(C)) are experts in treating injuries to the musculoskeletal system. Their comprehensive approach includes injury prevention, assessment, emergency and acute care, rehabilitation, and re-conditioning.   Athletic Therapy can reduce sick leave and lost work productivity, often with no added cost to most benefits plans. 

This informative session will be presented by Mélanie Levac, Executive Director of CATA, and Jordan Cooperman, Director of Member Engagement and Partnerships at CATA. 

Track: Dental

AI is not a distant future—it's here, reshaping how dental insurers operate and improving the experience for over 113M insured members today. From streamlining claims processing and credentialing to optimizing network management and enabling instant benefits decisions, AI is driving efficiency and better outcomes for both insurers and providers.

In this session, we'll go beyond the basics and dive into real-world applications, exploring:
- How insurers are using AI right now to enhance claims review, provider onboarding, and patient care.
- The latest AI advancements that are strengthening payer-provider relationships, like real-time benefits decisions and automated approvals.
- What’s next: the future of AI in dental and how it will continue to evolve the industry.

Track: Health & Disability

This session delves into understanding obesity as a chronic disease, examining its multifaceted causes and the necessity for comprehensive treatment approaches. Sandra Elia discusses the significant economic implications of inaction, highlighting how untreated obesity escalates healthcare costs and diminishes workplace productivity. Additionally, we’ll explore effective workplace strategies to support employees living with obesity, fostering an inclusive environment that promotes health and well-being.

Track: Life

As an industry, we increasingly look to the internet for an online obituary as a quick method of validating a death, which in many cases can expedite the claim process for beneficiaries and internal processes. Unfortunately, fake obituaries are online: the reasons for this are convoluted and not necessarily directly linked to our industry. But how do we watch for this without compromising our need for speed? Join us for a discussion to learn more about the phenomenon of Obituary Pirates, examples of how this appears online, and how it may creep into your claim evidence. Presenters will discuss key adjudication processes that should be a part of your adjudication toolkit to allow you to continue to use online evidence, and also to know when an investigative service provider should be used to validate a death.

Track: Disability

Join your colleagues for a discussion about disability litigation. 
You are invited to submit questions in advance through the Event App.

Track: Anti-Fraud

This presentation explores the cutting-edge industry-developed tools and collaborative approaches that are revolutionizing group benefits fraud investigations. As fraudsters become increasingly sophisticated, insurance carriers must adapt by harnessing the power of shared data and coordinated efforts.

During this 45-minute break, enjoy refreshments and connect with more Exhibitors. Remember to collect codes from exhibitor reps for the Conference Challenge!

Track: Health & Disability

A transdiagnostic bio-psycho-social-spiritual treatment model utilizing novel and evidence-based treatments may reduce disability claims and improve disability rates. Dr. Tanguay will explain how mental wellness can be achieved for those experiencing Mood Disorders, PTSD, Trauma, Anxiety, Depression, Addiction and Chronic Pain conditions with evidence-based psychotherapy delivered by inter-disciplinary medical teams. He will explore the evidence of the innovative treatments including ketaminea and psychedelics and support people to return to work and their healthy lives in a timely manner.

Track: Health

This session will focus on the cost savings associated with physiotherapy care with insight from the Deloitte Economic Report on the Impact of Physiotherapy. 

Track: Life

Learn about the various provincial programs that permit a qualified nurse to perform death investigations.

Track: Disability

Insurance claims processes need to be built on a realistic understanding of customers’ mindsets to make them truly effective. However people’s motivations are not always what we might expect. This can lead to challenges such as capturing incomplete or inaccurate information on application and claim forms, and delayed return to work after illness or injury. This talk will discuss RGA’s recent behavioral science research showing that by understanding and working with, rather than against, how customers think, insurers can create more effective disability claims journeys. The talk will share practical examples of how we have applied simple behavioral science-based techniques to achieve this.

Track: Anti-Fraud
New research sheds light on how sex traffickers are using hundreds of potentially illicit massage parlours as shell companies to launder and hide their illicit profits and the vulnerable people they prey on in Canada. This session will expose a hidden link potentially used by nefarious business owners and criminal organizations for monetary gain and uncover the health insurance fraud connection in Canada. Follow the money. 

Tour around the Exhibit Hall and enjoy lunch with colleagues! 

Lunch is sponsored by Platinum sponsors

Join your colleagues for lunch and a discussion about all claim types en français. Lunch buffet available for Francophone attendees in Grand Foyer 2.

After lunch, join us for coffee and dessert for a special plenary featuring guest speaker Dr. Timothy Meagher.

Track: Health & Disability

This session will delve into the critical connection between mental health, workplace wellness, and organizational success, focusing on how mental health initiatives directly impact productivity, innovation, and overall outcomes. Attendees will better understand the importance of empowering employees to choose their mental health providers, exploring how this autonomy enhances employee satisfaction and fosters trust. Through evidence-based insights, participants will learn how supporting mental health choice contributes to improved organizational performance, greater employee well-being, and a stronger return on investment (ROI).

Track: Health

The goal of the session is to highlight the advances in drug innovation and gaps in access to cancer care for working Canadians and to discuss the valuable role that private payers can play. As cancer cases rise and increasingly impact younger populations of Canadian workers, this session will aim to highlight current provincial disparities and inequities, illustrate current barriers of accessing diagnostic testing and infused therapies and identify potential solutions to ensure timely access to treatment for cancer patients in the workplace.

Track: Life

This session is an opportunity to broaden perspectives beyond individual claims into a deeper understanding of mortality trends. How do daily experiences fit into broader mortality patterns? What trends do we see across and within different populations? This session will include an analysis of historical mortality patterns as well as the current and significant mortality headwinds and tailwinds impacting experience, including socio-economic factors and the impact of COVID-19.

Track: Disability

We train claims managers, obtain medical records, utilize third party providers and manage expertise all by diagnosis and medical specialty. There are medical guidelines for disability durations based on diagnoses that help us predict the duration of time away from work and help us manage claims against expectations.
However, the industry has come to understand that psychosocial risk factors drive much of the difference between the claims that resolve and those that don’t. The industry has turned to finding methods of assessing, predicting, and managing psychosocial risk factors in claims that are complex.
In this presentation we argue that we haven’t gone far enough, because we still think about diagnoses that are impacted by psychosocial factors. It’s time to recognize that the problem is inherently the other way around.
Using both theory and data, we will bring this somewhat provocative idea to life, and present practical applications of how we should consider managing psychosocial factors, in this brave new world!

Track: Anti-Fraud & Disability

This one-hour workshop will delve into the complexities of disability fraud, with a focus on litigation.  We will cover the necessary documentation to support the denial of a claim, current trends in disability fraud litigation, and strategies for recoveries.  The session will also address the human element, such as cases where individuals on disability insurance fail to report supplemental income.

Booth Draw host: Joanne Wedgewood, Alberta Blue Cross and Conference Chair

Don’t miss your last chance to connect with over 40 exhibitors before the Exhibit Hall wraps up! Many exhibitors are showing their appreciation by participating in this year’s Exhibitor Draw Showcase. 

Visit participating booths, fill out a ballot, and drop it in their ballot box for a chance to win fun prizes. Winners will be drawn around 4pm—but remember, you must be present to win! 

Note: Exhibitors and sponsors are not eligible to participate in the draw. 

Closing Reception is sponsored by Silver sponsors.

Refresh, catch up on work, or chat with colleagues before the Special Event 

Dust off your cowboy boots and tie on your bandanas—it’s time for a night to remember at one of downtown’s most iconic venues: CRAFT Beer Market!
Mingle with fellow attendees, indulge in delicious bites from multiple food stations, and enjoy a round of bocce ball or a snap at the photobooth. Then get ready to two-step the night away with Alberta’s own country-rock duo, Flaysher!

Don’t miss the action in the games area hosted by our special event sponsor Alberta Blue Cross—where friendly competition meets serious fun.

CLHIA’s exclusive event takes over the main floor of CRAFT. The rooftop opens to the public at 8 PM, so come early and make the most of this private party!

Special event is sponsored by: Alberta Blue Cross

A Speaker Ready Desk is where speakers can check in with staff, review slides, and ask questions related to their presentation.

Check-in and pick up your badge

Enjoy breakfast while attending a Sunrise Talk. See the agenda for session room allocations. 

Seating is also available in Imperial 5. 

Explore how innovative neurorehabilitation tools like PoNS (Portable Neuromodulation Stimulation) are enabling plan members with brain injury, stroke, and MS to achieve functional gains, reduce fall risk, and successfully transition off long-term disability.

Discover how AI and collaborative data can revolutionize FWA detection in Canadian disability claims. This session will break down how Shift’s AI can uncover FWA by learning from data and adapting to uncover emerging schemes and additional bad actors. See how combining info from regulatory data, internal systems, and other LOBs creates a full picture of activity. Learn how uncovering hidden links and analyzing documents helps catch FWA faster and smarter. Join us to explore the future of fraud fighting with AI and collaboration.

What you’ll take away:
•    How AI adapts to new fraud schemes in disability claims
•    The power of combining data from all LOBs provide deeper insights
•    Ways to uncover suspicious relationships between providers, beneficiaries and other facilities to detect complex, high-value cases

Gain insights into how health profession regulation serves health benefits insurers’ clients and why validation of the Athletic Therapist’s practice status with AT-ON is needed to confirm professional standing in Ontario. Statutory Regulation was the intention of the profession’s founders in Ontario over 50 years ago.  Regulation provides critical proof of competency validation given the profession’s role in emergency medical care, first responder duties, concussion care, and unique position of trust in caring for elite, amateur, and professional athletes, as well as those engaged in the athletic pursuit of daily living. 

Sleep apnea and related disorders are highly prevalent, requiring increased awareness, collaborative and personalized care with quality diagnostics, and demonstrated value to lessen public health and economic impact. Diagnostic advances will improve access, projecting over 5% industry growth. Desired outcomes include greater awareness, better care, reduced burden, and proven value.

Track: Health

This session will provide an update on drug trends across private drug plans in Canada and an overview of the pharmaceutical marketplace.

Track: Health

In this session, hear from a lawyer that specializes in this field. Why is this benefit increasingly valued by employees? What are the key considerations and potential risks? What costs should be reimbursed and to what extent? This session will provide you with all of the key information to implement and manage claims on behalf of your customers.

Track: Life 

What is accelerated underwriting and how can this type of underwriting impact the claim process? In this panel discussion, learn about the pros and cons of accelerated underwriting and how claims and underwriting can partner together to mitigate risk and identify trends to improve overall outcomes.

Track: Disability & Health

Mental health is at the forefront of Canada’s evolving healthcare landscape, and occupational therapy (OT) plays a vital yet often underrecognized role in supporting individuals on their journey to recovery. In this engaging session, our national allied healthcare company will explore the essential contributions of OT in mental health, unpacking its impact on patient outcomes and healthcare system efficiencies.
We’ll delve into the pressing challenges facing OT practitioners today, including access barriers, resource constraints, and the growing complexity of patient needs. With changes in the healthcare system accelerating, we’ll discuss how OTs are adapting to deliver impactful services that address the unique challenges of mental health care.

The session will highlight key OT services, including personalized strategies to improve daily functioning, emotional resilience, and overall quality of life for individuals living with mental health conditions. We'll also discuss opportunities to enhance collaboration between OTs and the broader medical community, creating a more integrated and effective care model.
Through real-world examples and practical insights, attendees will gain a deeper understanding of how occupational therapy bridges the gap between mental health care and holistic recovery. Whether you’re a healthcare professional, insurer, or policymaker, this session offers actionable strategies to foster collaboration, innovation, and better outcomes for Canadians navigating mental health challenges. Join us to learn how OT can transform lives—and help shape the future of mental health.

Track: Anti-Fraud
Fraudulent claims continue to pose a significant challenge for life and health insurers worldwide, impacting both operational efficiency and financial stability. In this session, we delve into the latest findings from RGA’s 2024 Global Claims Fraud Survey, which gathered insights from 83 insurers across the globe. We will highlight global trends, challenges faced by insurers in fraud detection and prevention, and explore innovative strategies to combat fraud. There will be additional information on Canadian insurers and how they are adapting their approaches and solutions.

Join your colleagues for a discussion about health and dental claims. 
You are invited to submit questions in advance through the Event App.

Track: Life & CI

Join your colleagues for a discussion about life and critical illness claims. 
You are invited to submit questions in advance through the Event App.

Track: Disability

Join your colleagues for a discussion about disability claims. 
You are invited to submit questions in advance through the Event App.

Track: Anti-Fraud

Join your colleagues for a discussion about anti-fraud. 

Join us for lunch at our final plenary and hear from keynote speaker Camille Dundas. We will close the conference with a few special announcements following our keynote speaker.