Special Investigation Unit (SIU)
Definition
A dedicated anti-fraud team within an insurance company, required in the US by the Insurance Fraud Prevention Model Act, in the UK by FCA regulation, and in India by IRDAI guidance, which investigates suspicious claims including suspected arson fraud.
- Function
- Dedicated anti-fraud team within an insurance company
- US basis
- Insurance Fraud Prevention Model Act
- UK basis
- FCA regulation
- India basis
- IRDAI guidance
- Casework
- Investigates suspicious claims including suspected arson fraud
Common questions
What triggers a claim being referred to an SIU rather than handled by a normal claims adjuster?+
Red flags such as inconsistent statements, a recent policy increase before a loss, financial distress of the insured, or fire origin and cause findings pointing to incendiary rather than accidental ignition typically prompt referral to the SIU for deeper investigation before the claim is paid.
Does an SIU replace the need for an independent fire investigator or forensic accountant?+
No, the SIU coordinates the investigation and often commissions independent fire origin and cause experts and forensic accountants to examine the physical and financial evidence, functioning as the internal unit that manages and acts on their findings rather than performing that technical analysis itself.
Related terms
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