My group fought into the luggald caves, taking the secret door to the left (north) of the Gunthak zone in Dulak's Harbor. We fought to the first bridge, then went east (Chester and Soulstealer camps). We killed every luggald along this route, and by the time we reached the end of the last room, we'd found one insignia of hatred and one insignia of slaying, and had taken less than an hour to collect them.
My group got one of these last night in Nadox, but it was called Medallion of Hatred. Looked the same as this...no stats, just a card. Not like actual Medallion of Hatred which is neck piece for Cleric, Druid, Shaman.