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
