Industry experts agree that between 10 and 15% of all insurance claims involve some type of fraud or abuse. In California the problem of insurance fraud is so severe that the insurance commissioner has deemed it one of his top three priorities.

Most states have laws mandating that all insurance companies carriers have
an anti-fraud plan in place. They frequently require formal reporting of
suspected fraudulent cases, and that the carrier maintain a Special
Investigations Unit (SIU).

Capital Claims Services supplements many SIU's. We are also a designated
contract SIU for those carriers/administrators that are not able to staff a
unit full time.

At CAPITAL, we have the expertise, capabilities, and resources to assure that your company meets the strict regulatory requirements imposed by "state laws" as it relates to fraud prevention and investigation.

Our SIU consultation services include:
  • Developing and filing a specifically tailored, integrated fraud plan with the State Department of Insurance
  • Filing annual SIU compliance reports with the Fraud Division.
  • Conducting fraud awareness training for your integral company personnel.
  • Developing a tailored new hire orientation fraud awareness program.
  • Providing a quarterly fraud awareness newsletter.
  • Participating in any Department of Insurance Fraud Division SIU compliance audit.
  • Providing SIU quarterly management disposition reports.
  • Providing investigation of suspicious claims.
  • Referring suspicious claims to the Department of Insurance Fraud Division.
  • Referring documented criminal prosecution of fraudulent claims to local district attorneys.

Capital Claims Services is ready to be your Special Investigations Unit service provider. Please contact us at 866-835-8121 to learn more about our services and how we can help you comply with State law."