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Fraud Investigation

Special Investigations Unit (SIU) & Fraud Investigation

At Contego, gone are the days of “silo insurance”, where a suspect claim or company exposure makes weekly rounds through many different and segregated departmental discussions. Instead, our SIU philosophy is a “front to back – back to front” collective company attack for handling suspicious claims and exposures from the onset of a claim.

By activating the SWARM™, we ensure that all departments are communicating with one another so our field response teams know exactly what is needed to maximize control of a situation and minimize exposures going forward. This global communication dramatically improves the timeliness and quality of our response.

SIU and Fraud Investigation benefit immensely from the SWARM™ service model due to the fact that many different departmental fact finders are relaying important information back to SIU and Fraud Investigation to build a case. Essentially, our SIU and Fraud Investigation departments piece everything together for a complete work product that helps our clients to make an informed decision regarding an insurance claim.

Our SIU and Fraud Services:

  • Anti-fraud plan development
  • State compliance
  • Anti-fraud training
  • Research and data analytics
  • Due diligence
  • Field investigative oversight
  • Investigative plan development
  • Law enforcement conduit
  • Fraud referral filing
  • Fraud prosecution
  • Pursue restitution
  • Investigate medical provider fraud
  • Clinic inspections
  • Examinations under oath
  • Premium fraud investigations
  • 24/7 Fraud hotline

What Sets Us Apart

  • Review of every First Report of Injury (FROI)
  • Review of every investigative report
  • SWARM™ approach to catastrophic claims
  • 24/7 operation of dozens of fact finders
  • Dedicated Fraud Manager overseeing law enforcement referrals
  • Relationships with local, state, and federal agencies, making fraud referrals and investigations run smoother and conclude faster than other SIU departments

Please complete this form to learn more about our insurance SIU & fraud investigation services. One of our representatives will contact you shortly.