Log in or register
Share on LinkedInShare on LinkedIn

ARTICLE · 06 NOVEMBER 2023

What Is A Special Investigations Unit?

KI Legal
Explore more from KI Legal

When insurance companies deem a personal injury claim to be suspicious in some way, they are sent to a special investigations unit, or a SIU.

United StatesInsurance
Michael Iakovou
Michael Iakovou
Gregory Pinkhasov
Gregory Pinkhasov
Author LinkedIn connections

When insurance companies deem a personal injury claim to be suspicious in some way, they are sent to a special investigations unit, or a SIU. What is a special investigations unit? A special investigations unit is essentially an insurance company's fraud division, which is tasked with investigating any claim sent to it as fraud. The insurance adjustors who work in SIU departments are often former law enforcement personnel, including members of the FBI.

What Types of Cases Go to the SIU?

There are a few common scenarios that significantly increase the chances that a claim will get sent to an insurer's SIU, including -

  1. The most obvious case is when there are clear indications of the claim being fraudulent.

We operate a free-to-view policy, asking only that you register in order to read all of our content. Please login or register to view the rest of this article.

Register for freeORLog in

View source

Related Articles

Legal Intelligence Newsletters: sign up for the latest legal and regulatory news on your chosen topics

Read more about

Related Comparative Guides

See more popular content from

Article

Privacy, Cyber & Data Strategy Advisory | NAIC Summer Meeting Sharpens Focus On AI, Data, And Technology Governance

The National Association of Insurance Commissioners intensified its regulatory focus on artificial intelligence governance, third-party data models, and cybersecurity oversight at its Summer 2026 meeting. Regulators are shifting from principles-based guidance to examination-ready supervisory tools, emphasizing that insurers remain accountable for the technologies and vendors they deploy. The meeting revealed how AI risk evaluation, vendor oversight frameworks, and privacy modernization efforts are convergin
United StatesInsurance
Alston & Bird LLP
Alston & Bird LLP
Article

AI Regulation In Insurance: A Crossroads

As artificial intelligence development accelerates and safety concerns mount, state insurance regulators are advancing comprehensive examination frameworks to govern AI use in the insurance industry. The National Association of Insurance Commissioners nears completion of its AI Risk Evaluation Supplement, which will establish standardized oversight procedures for insurers' AI governance practices across market conduct and financial examinations.
United StatesInsurance
McDermott Will & Schulte
McDermott Will & Schulte
Article

US NAIC Summer 2026 National Meeting Highlights: Natural Catastrophe Risk And Resilience (EX) Task Force

The Natural Catastrophe Risk and Resilience Task Force of the US National Association of Insurance Commissioners convened to address the escalating challenges of catastrophe risks facing insurance markets. Key discussions centered on developing standardized mitigation programs, expanding flood insurance awareness, and scaling resilience initiatives like FORTIFIED home designations. The meeting also examined the evolving property/casualty reinsurance market and explored new hemispheric partnerships to streng
United StatesInsurance
Mayer Brown
Mayer Brown
Article

Is Your PFAS Coverage At Risk? An Ohio Federal Court Ruling Opens The Door To Broader Insurer Denials

A federal court in Ohio has ruled that an occupational disease exclusion in a commercial general liability policy bars coverage for PFAS-related personal injury claims brought by firefighters against a manufacturer of firefighting equipment. This landmark decision could significantly impact how insurers respond to PFAS product liability claims and may extend beyond occupational disease exclusions to other policy provisions using similarly broad language.
United StatesInsurance
Benesch, Friedlander, Coplan & Aronoff LLP
Benesch, Friedlander, Coplan & Aronoff LLP
Article

Contractual Liability Exclusion Must Be Assessed Against Each Cause Of Action Separately, Not Applied Wholesale Where Multiple Claims Are Pleaded In One Action

The Ninth Circuit Court of Appeals examined whether a directors' and officers' liability policy's contractual liability exclusion could bar coverage for an entire multi-count lawsuit, or whether each legally distinct cause of action—breach of contract, fraud, and quantum meruit—must be assessed separately against the exclusion's terms. The decision addresses the critical question of how insurers must apply policy exclusions when a single complaint pleads multiple claims arising from the same und
United StatesInsurance
Adams & Adams
Adams & Adams
Article

Don’t Try To Deny It: Federal Court Holds FCA Settlement Is Covered By Insurance

A federal court ruled that CNA must provide coverage for Guidehouse's $7.6 million False Claims Act settlement related to cybersecurity failures in New York's Emergency Rental Assistance Program portal. The decision addresses critical questions about when insurers can deny coverage for FCA settlements under professional liability policies, particularly regarding exclusions for fines, penalties, and deliberate acts.
United StatesInsurance
Crowell & Moring LLP
Crowell & Moring LLP