Insurance Fraud

Special Investigation Unit (SIU)

It's not the name of the newest hit TV police drama, but given the amount of money at stake, it is a sign of the times. Property and casualty insurance fraud cost insurers about $30 billion in 2004; according to the Coalition Against Insurance Fraud, almost half that total-$14 billion-came from auto insurance fraud alone.

Insurance companies who refuse to treat insurance fraud as a cost of doing business have established SIU departments and the results speak for themselves. In 2004 and 2005, the Mid-Atlantic Insurance Group estimated that SIU investigations resulted in a saving of $5.7 million dollars that could have been paid out on fraudulent insurance claims.

"All claims associates are trained to recognize the red flags that are associated with potentially fraudulent claims," says Gregory Sacco, SUI manager for the Mid-Atlantic Insurance Group. "When they find any potential flags, they refer the claim for review by the SIU manager, who will look at the referral to determine if it merits an investigation. If it does, that claim is assigned to an investigator who will investigate to determine if there is any fraud or misrepresentation involved in the claim."

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