Fraud takes many shapes. From the simple omission of a fact by an insured in an effort to have their questionable claim covered by an insurance company to an elaborate scheme perpetrated by a organized fraud ring, Covert Special Investigations has the experience to be your front-line defender in this battle of good vs. evil. Admittedly, the insurance industry has a vulnerability to fraud. In the processing of thousands of claims a day, it is unrealistic for a company to examine even 5% of those suspicious claims. This vulnerability has given rise to the establishment of Special Investigation Units whose sole responsibility is to investigate claims which have suspicious indicators or "red-flags." 

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From the initial referral, we will communicate our progress with your claims and SIU staff. We will provide a recap of the referral and our initial investigative plan. We will then provide written or verbal updates (as preferred by each client) along the way through a typical fraud investigation which generally includes some or all of the following:

• Initial contact with an insured/claimant

• background investigation

• Social media search

• Initial recorded interview(s) with the insured / claimant / passengers / employers

• Collection of supporting documentation (i.e. cell phone records, bank records, lost wage documentation and etc.)

• Collection of public records (i.e. police and fire reports, motor vehicle records and etc.)

• Vehicle / scene inspection

  • EDR Crash Data Download (if necessary)​

• Scene canvass for witnesses / surveillance video

• Follow-up interviews with any potential witnesses

• Coordination with NICB (for member companies) and Department of Insurance

• Submission of state mandated fraud referrals to NICB / DOI

• Examination Under Oath (if requested)

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We will also work with your claims staff to address any specific areas of concern to ensure no questions are left unanswered. Our SIU services are tailored to fit your needs. If you just need boots on the ground to handle the field work for your desktop SIU investigators or you need a full-service SIU Investigation, we are your one-stop shop for all of your investigative needs.  

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Below are some stats regarding our investigations from 2021 as it relates to our work with one insurance carrier who contracts us for their SIU Investigations vendor. Does your current vendor provide the same results