The Special Investigative Unit

The Special Investigative Unit (SIU)is a part of every insurance company in the US, but when the insurance adjuster tells you that he or she is referring your damages or personal injury claim to SIU, what exactly does that mean? It means that something in your claim has raised an alert to the insurance company that fraud might be involved. This might be an alert against you or another person involved in the claim.

Every insurance company handling claims in the US (and most other countries) has such a Special Investigative Unit. Any given insurance company’s SIU division is made up of claims adjusters who have extensive insurance claims knowledge as well as (usually) law enforcement experience. The unit’s mission is to detect, prevent, and document insurance fraud. They cooperate with the law enforcement community, including but not limited to the local police, NICB (national insurance crime bureau) and the FBI; these organizations also contribute to the continuing training of SIU members. Most prosecuted fraud cases are based on evidence uncovered and collected by SIU adjusters.

SIU adjusters investigate a wide range of suspect claims including, but not limited to, possible staged accidents and vehicle thefts to questionable injury claims to suspect medical treatment. If your claim has been referred to SIU for further handling, expect an investigation that is much more thorough than typical. You may be asked to submit to examinations under oath (face-to-face questioning before a court reporter). The investigation may involve extensive background checks, including medical, as well as surveillance.

Claims are not lightly referred to SIU. Such handling is more expensive to the insurance company because they involve more involved and costly investigation, and because the SIU adjusters carry lighter case loads. If a claim is referred to SIU, it is because the insurance company believes that it has a strong case of fraud. You might want to check out our list of key insurance fraud indicators.

If you are told that your claim is being referred for SIU handling, you would want to ask why. Is it because you seem suspicious, or because of someone else involved in the claim? If you are the party being investigated, expect to be put through the wringer. You might even consider hiring an attorney if you do not already have one. If someone attempting to make a claim against you is the one being investigated, you can be assured that your insurance company is making exceptional efforts to protect you against a potentially fraudulent claim.

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