INVESTIGATIVE SERVICES
GOVERNMENT REGULATION Effective in 1997, the New York State Department of Insurance, in Regulation 95, mandated that all insurance companies doing business in New York, including those headquartered in other states, must have SIU investigators. This regulation requires either an in-house SIU group or the use of an independent private investigative agency/SIU contractor. Both alternatives require the submission of an acceptable anti-fraud program. New York State Insurance Companies For New York State-licensed insurance companies, Certified SIU is a competent and effective adjunct to your in-house SIU capabilities. Out-of-State and Smaller Companies Pursuant to Regulation 95, out-of-state and smaller insurance companies may use the services of an independent contractor. Certified SIU has the experience and proven expertise to be your SIU investigator. In fact, we are expert at being the local "arms and legs" for your insurance company.
Certified SIU Services uses established and proven procedures to conduct investigations. We are a full-service professional investigative organization which provides the means to promptly evaluate and settle good claims as well as identify and deny fraudulent claims. We not only investigate your claims, but are prepared to aid and assist clients in defense preparation. When necessary, we can refer said cases to the appropriate frauds bureau, law enforcement agency or prosecutor.
Technological Expertise Our in-depth database accessibility enables Certified SIU to locate witnesses, claimants and insured persons. We conduct complete background investigations through address updates, social security searches and Department of Motor Vehicle inquiries in most states. We also create in-depth personal profiles of our subject to aid in your investigation. All of our investigative clerks are computer literate and conduct a wide variety of inquiries on-line, with most answered the same day. We also conduct document retrievals, corporate searches and Dun & Bradstreet reports. Locating Insureds and Witnesses We are proud of the fact that 75 percent of all cases investigated are successful in locating insureds and witnesses. The value of our ability to locate missing persons translates to a reduced number of judgement-pending files for our clients. This information permits them to settle cases for a reasonable rate rather than having excessive court-mandated judgements placed against them. Investigations Whether it be taking a statement from an insured/claimant in an accident case or investigating a suspicious claim, our operatives conduct complete in- depth interviews and investigations. We obtain critical information that enables your claims department to make those important claim decisions regarding whether to settle, defend and, in many cases, investigate further or deny. Surveillance Our audio and video capabilities are second to none. We conduct in-depth investigations of workers' compensation, bodily injury and disability claims. We employ full-time surveillance teams using state-of-the-art equipment and our own equipped vans. We use numerous undercover concealment's of electronic audio and video equipment to identify fraudulent or validate legitimate claims. One of the prerequisites to a successful surveillance is the use of our pre- surveillance investigation techniques. Through the use of our sophisticated databases, we locate the subject and his or her residence prior to actually conducting the surveillance. Certified SIU's multiple surveillance teams are fully equipped and are available for your assignments in or out of New York State. Forensic Document Examination We rely on the auspices of an in-house forensic document examiner, whose work reviewing and verifying original records and transcripts results in millions of dollars of savings each year for our clients. These services are used mostly in the investigation of medical, no-fault and workers' compensation claims. We have uncovered numerous instances of fraud or misrepresentation in the bills submitted for services rendered by various medical and service providers. Our unique method of investigation in these matters usually results in substantial savings. In fact, one insurance company reports savings of $4 million per year simply based on our document examination efforts. Police and Prosecutor Friendly Because of their background in police work, our investigators know their way around local police departments and work closely with law enforcement within their coverage areas. Certified SIU can present cases to the proper investigative agencies including the police and/or prosecutors with the assurance that there are no loose ends. Training and Education We offer a variety of educational seminar programs to help insurance companies identify suspicious claims and combat fraud. Programs, typically directed to claims representatives, are hands-on sessions provided by our expert investigators at the location of your choosing. Recent topics include: Identifying and Investigating Fraudulent No-fault and Workers Compensation Claims, Indicators of Insurance Fraud and Identifying and Pursuing Insurance Fraud.
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