What is a Special Investigation Unit (SIU)?
A Special Investigation Unit (SIU) is a specialized team within an insurance company that focuses on detecting, investigating, and preventing insurance fraud. These units play a vital role in the claims process by verifying that claims are valid—and protecting policyholders from the financial impact of fraudulent activity.
At Sentry, our SIU is dedicated to thoroughly evaluating claims that raise questions and working to resolve them quickly and fairly so legitimate claims can move forward without unnecessary delays.
Why a claim may be referred to an SIU
It’s natural to have questions if your claim is being reviewed by an SIU. A referral doesn’t automatically mean wrongdoing; it simply means the claim requires additional review. Common reasons a claim might be referred include:
Inconsistent or incomplete information in the initial report
Unusual circumstances surrounding the loss
Higher-value claims that require additional documentation
Multiple claims in a short timeframe
Obviously, some or all of these circumstances may be out of your control. And again, an SIU investigation doesn’t necessarily mean there’s anything wrong with your claim.
To help reduce your likelihood of having your claim reviewed by an SIU, provide as much detailed and timely information as possible when you submit your first notice of loss (FNOL).
What happens during an SIU investigation
If your claim is being reviewed by an SIU, here’s what you can expect:
Initial review: The SIU will analyze claim details, documentation, and related evidence.
Requests for additional information: You may be asked for further documentation, such as photos, receipts, or statements.
Interviews or recorded statements: The investigator might conduct interviews with you or other involved parties to clarify details.
Final determination: Once the review is complete, the claim will either proceed as normal or additional steps will be taken if fraud is confirmed.
How SIUs help prevent fraud
Insurance fraud costs providers and policyholders billions of dollars annually, impacting everyone by driving up premiums and limiting resources for legitimate claims. SIUs play a critical role in reducing these risks.
Learn more and manage your claims
If you have questions about your claim or want to learn more about how we protect the claims process, visit our Claims Center.
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