Surveillance Services

Activity Checks

Most commonly used to conduct a pre-site investigation to determine if a full Video Surveillance investigation is warranted. The Activity Check Investigator will facilitate a neighborhood canvass, background study and obtain photos of the subject’s property.

Video Surveillance

At SIU Central, we realize that there are multiple providers that offer Video Field Surveillance. However, SIU Central differs, in that each file is reviewed by our staff Fraud Investigator with recommendations and suggestions (at no extra charge) that will assist the claims professional in organizing the appropriate Fraud Plan. All video surveillance is conducted utilizing seasoned State Licensed Investigators who practice ethical and discreet video documentation.

Claims/Field Investigations

Recorded Statements-AOE/COE

This highly sought after process provides the opportunity to obtain audio documentation of specific events and occurrences as they relate to a specific claim. Statements of the claimant, witness and employers are conducted and will prove to be a valuable tool toward the direction of a particular claim. As with all investigations, scene diagrams, documents and photos are obtained with each statement ordered.

Witness Statements

The ability to extract information, capturing valuable data from individuals within the area of an occurrence, providing a priceless resource for current and future claim use. The accuracy and value of a witness statement will help to reduce exposure and better secure potential rights toward future subrogation.

Accident/Scene Investigations

This onsite resource provides the file handler with up to date information on the specifics of an accidental occurrence. This investigation of the accident or incident location includes: photographs, measurements, traffic and traffic control devices, and any other circumstances relating to the accident or incident.

Subrogation Investigations

As with most new claims, time is of the essence, therefore, our Subrogation Specialist is a highly skilled individual trained to conduct on-site accident scene investigations. Our Subrogation Specialist maintains the ability to provide money saving evidence necessary when seeking a right of reimbursement. (Subrogation inquiries are conducted on all general recorded statements.)

Alive and Well Checks

This onsite investigation involves an announced or unannounced interview to confirm a subjects living or deceased status, receipt of benefit checks, general health, and activity level.

Clinic Inspections

Comprehensive assessment of assigned medical facilities ensuring that charges for ancillary services are accurate and performed utilizing equipment that is on site and accessible by the facility staff. Traffic logs of daily activities can also be obtained running vehicle tags documenting clinic patient flow. This tool has become increasingly important in the fight against fraud with the increase in fictitious medical practices being at an all time high.

BACKGROUND INVESTIGATIONS

Comprehensive Medical Sweep

A valuable investigative technique performed to verify the location and dates of a person's prior medical treatment. This service is often utilized by file handlers when investigating for pre-existing conditions and or to confirm the validity of a person’s stated medical history. Includes, a search of 6 facilities within each of the following specialties: Hospital, MRI, Walk-in, Pharmacy and Orthopedic. Note: SIU Central Inc. will obtain records for an additional charge.

Comprehensive Medical Sweep

A valuable investigative technique performed to verify the location and dates of a person's prior medical treatment. This service is often utilized by file handlers when investigating for pre-existing conditions and or to confirm the validity of a person’s stated medical history. Includes, a search of 6 facilities within each of the following specialties: Hospital, MRI, Walk-in, Pharmacy and Orthopedic. Note: SIU Central Inc. will obtain records for an additional charge.

Pharmacy or Hospital Sweep

Specific medical facility study encompassing up to ten separate entities allowing the licensed adjuster the opportunity to determine treatment patterns and prior treatment dates.

Background Investigations

This excellent resource is available and frequently utilized to verify a physical location of a claimant as well as document his/her civil and criminal history. This valuable tool verifies existing information regarding a subject. Includes current address and address history, vehicle and vessel registration, property ownership, criminal and civil history, asset search, bankruptcies/liens/judgments, UCC filings, and state driving record. The Background study in conjunction with other services such as Video Surveillance and or Recorded Statements should be considered at the inception of a claim.

SIU SERVICES

Fraud Investigations

A contracted service offered to Carriers, TPA’s and Self Insured’s whereby each file is meticulously reviewed with an opportunity to identify red flags. Upon the recognition of red flags, a detailed plan of action is provided whereby appropriate investigations are implemented in an effort to provide evidence collection, documenting fraudulent acts as committed by individuals, corporations and or fraud rings.

Fraud Referrals

As required by multiple states, the reporting of any and all suspicions claim activity allows for the tracking of criminal activity and the potential prosecution of those who seek to defraud the insurance industry. The conversion of a civil to criminal case is performed through meticulous file review while preparing evidence in such a manner as to encourage state prosecutors to review and conduct their own independent investigation of the data received. This service is conducted on a case by case basis or under contractual commitment.

State Compliance Reporting

A service that is required by multiple states allows for the carriers to defer the obligation of such tedious acts to an independent organization. Under contractual commitment, SIU Central, Inc. will prepare all applicable documentation conducting file reviews and fraud audits in an effort to finalize and submit the required forms for state compliance.

Vendor Compliance

In an effort to properly monitor the success rates of vendors providing services to the carrier, a vendor compliance program is being offered whereby vendors must submit proper insurance, credentials and work histories. Once approved as a suitable candidate, vendors are then monitored and scrutinized regarding their performance and contributions toward providing results that translate into savings for the Carrier, TPA and or Self Insured.

ADDITIONAL SERVICES

Continuing Education Seminars (Live Instruction)

SIU Central Inc. currently offers two separate continuing educational programs.

By enrolling in the FRAUD 101 program, adjusters are educated on the growing trends of fraud and the general public’s perception of the insurance industry. The program provides the adjuster with one free ethics credit.

By participating in RED FLAG Training, the adjusters and case managers are educated in the latest fraud identifiers and techniques utilized to combat such fraudulent acts. This program provides one free general elective credit.

Please note, these programs are high energy and interactive requiring audience participation. The programs are best suited and typically utilized as a lunch and learn.