SIU & Fraud Investigation

Front to Back – Back to Front Philosophy

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.

Contego’s 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

 

Contact SIU & Fraud Investigation

SIU & Fraud Investigative Contacts

Trish Donaven