SIU and Fraud Investigation

The FBI estimates that the total cost of insurance fraud, excluding health insurance, is more than $40 billion per year. Whether committed by organized criminals conducting fraudulent business activities, professionals or technicians inflating service costs or charging for non-rendered services, or ordinary people looking for an opportunity to make money, insurance fraud accounts for approximately 10% of the property and casualty industry's incurred losses and loss adjustment expenses each year.

Envista's experienced SIU investigators are experts at detecting fraudulent activities and supporting legal action in cases such as:

• Accidents
• Fraud-related fires
• Engine seizures and watercraft claims
• Malicious computer or data system activity
• Suspicious or overstated property damage estimates
• Reduction of inventory or theft
• Waste or abuse
• Water claims, flood, or failed water components

With 20 years of experience conducting fraud investigations in both the public and private sector, Envista's highly experienced SIU forensic consultants analyze data, evidence, and digital technology to help companies detect fraud, identify liable parties and mitigate their risk. We have been trusted by claims and legal professionals all over the world to assist with private, sensitive, and high-profile investigations.

Process for an SIU Investigation

Our process can involve interviews, evidence collection, on-site visits, and collaboration with internal and external parties to produce a verified report and/or testify in court proceedings.

Envista keeps technology at the forefront of everything we do. To strengthen our investigations, our experts can use 3D imagining technology for evidence collection and scene documentation, as well as UAV/drone technology to gather and better illustrate the full scene or obtain evidence from unsafe or out of reach environments. Once a 3D digital site documentation file is created, it allows for easy remote "walk-throughs" for party collaboration and review, or to use in court proceedings.

Special Investigation Unit Experts

Our licensed private investigators, all of whom have prior law enforcement or public fire investigation experience, are specifically trained in applicable laws surrounding special investigations. They are well versed in:

• Using investigative techniques required during scene documentation, data collection, and evidence collection and preservation
• Conducting skilled interviews (oral, written, and recorded) and laws related to interviews
• Recognizing deception during interviews
• Constructing proper document verification, including medical, billing irregularities, and pharmaceutical abnormalities
• Understanding of bad faith, the investigative process, and investigators' powers under the policy
• Court proceedings and the deposition process

Sources:

https://www.fbi.gov/stats-services/publications/insurance-fraud

https://www.iii.org/article/background-on-insurance-fraud