What Does SIU Mean in Accident Claims?

In the context of auto accident insurance claims, the acronym SIU refers to “Special Investigation Unit.” All the big auto insurance companies have an SIU of some type. The primary purpose of these investigation teams is to uncover fraudulent claims activity in auto accident cases.

special investigation unitInsurance companies seem to think that auto accident claim fraud is widespread and pervasive. I disagree with this view as to how prevalent claims fraud is. However, there is no dispute that many car accident claimants either exaggerate their injuries or even make them up entirely.

What is an SIU?

In the world of insurance injury claims, “SIU” means “Special Investigation Unit.” Almost all insurance companies have special investigation units (SIUs), although the actual name of the unit may vary depending on the insurer. The core purpose of SIUs is to root out fraudulent injury claims. The SIUs seek to determine whether victims in car accident cases are exaggerating the scope of their injuries, getting unnecessary medical treatment to try to increase the value of their case, or even staging the car accident. As GEICO explains, the goal of an SIU is “to detect, deter, and defeat insurance fraud.”

Good car accident lawyers in Maryland understand that SIU units serve an important function and are beneficial. Why? Because ridding the system of fraudulent accident claims leaves a larger pie – and a more differentiated pie – for people who suffer legitimate injuries in car accidents and deserve full compensation.  When insurance companies payout on claims that are fraudulent, it takes money away from valid claimants.  Standing and fighting against fake accident claims is the best thing insurance companies can do for truly deserving victims.

What Is the Goal of SIU?

In my own practice, it has been years since any of our auto accident cases triggered an SIU investigation. The reason for this is simple. We are selective about the type of car accident cases we take. Absent some compelling circumstances, we do not take auto cases involving only “soft tissue” injuries. Why? Because soft tissue injuries are highly subjective. These are exactly the types of injuries that tend to invite exaggeration and fraud. Moreover, juries are keenly aware of this fact and they tend to view subjective, soft tissue injury cases with a high degree of skepticism.

This is why most SIU investigations involve claims based on soft tissue injuries. If you have a case under SIU investigation, the best way to handle it is by being proactive. Taking a “wait and see” approach can be a big mistake when it comes to SIU investigations. The best strategy is to confront the issue head-on. If possible, contact the SIU investigator and find out why they are suspicious. Then do your own investigation of the claim and provide additional information that might help clarify some confusion and assure the SIU that your client is being honest. If your investigation reveals strong suspicions of fraud, you should probably withdraw from the case.

Interesting GEICO Perspective

One thing I found of interest in writing this post is GEICO’s advice on dealing with potential fraudulent claims. They tell their insureds to “look out for large, older vehicles with three or more occupants.” This sounds a bit like profiling to me. Should we also be on the lookout for poor people? I mean, it might be statistically true, but it seems a little ill-advised to point this out.

Besides, do they really think someone will drive around keeping an eye out for crowded “older vehicles” and then steer clear of it to protect their insurance company from claim fraud? Shouldn’t GEICO be advising people to focus on driving safely rather than encouraging them to make driving decisions based on irrational paranoia? It really makes you wonder who is writing this garbage for GEICO.

And, if you have a meritorious claim assigned to GEICO’s SIU, just file suit.  GEICO will never make you a reasonable offer in those cases, if my experience is any indication.  If you have an explanation, save it for GEICO’s in-house defense lawyer assigned to the case who is far more likely to have an open mind that the insurance claims adjuster.

What to do if your claim goes to SIU?

If you bring a fraudulent auto accident claim and it gets flagged for SIU investigation, I would strongly advise you to drop your claim and go away as quickly and quietly as you can. If the SIU investigation uncovers evidence, you could end up facing criminal charges for fraud. Not to mention the fact that you are hurting a lot of innocent victims who have legitimate claims. If you have a legitimate claim and it comes under SIU investigation, you should retain a lawyer right away. Even if the SIU investigation uncovers no evidence of fraud, it is highly unlikely that the insurance company will settle your claim out of court. They will almost certainly take the case to trial in the hopes that the jury will have the suspicions that prompted the SIU investigation. As long as your claim is legit and you are totally honest, you should still win at trial more often than not.