SIU and Fraud Investigations

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The FBI estimates that the total cost of insurance fraud, excluding health insurance, is more than $40 billion USD 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 percent of the property and casualty industry’s incurred losses and loss adjustment expenses each year. 

Our experienced SIU investigators can assist with cases such as:

  • Accidents
  • Arson
  • Engine seizures and watercraft claims
  • Malicious computer/data system activity
  • Suspicious or overstated property damage estimates
  • Reduction of inventory or theft
  • Waste/abuse
  • Water claims/Flood, or failed water components

With nearly 20 years of experience conducting fraud investigations in both the public and private sector, Envista’s highly experienced 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, onsite 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, and to help strengthen our investigation, our experts can utilize 3D forensic scanning 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. This technology allows for easy, remote “walk-throughs” for party collaboration and review, or to use in court proceedings. 

SIU 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: 

  • Utilizing investigative techniques required during scene documentation, data collection and evidence collection and preservation.
  • Conducting skilled interviews (oral, written and recorded) and the corresponding laws pertaining to each.
  • 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, as all have testimony experience.

 

 

Sources:

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

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