Anti-Fraud SIU

CONTRACT SIU PROGRAM

Woodall & Broome’s Contract SIU program includes the design and implementation of a comprehensive Anti-Fraud program which is both compliant and cost-effective in any jurisdiction. Our Contract SIU investigators are proficient in handling suspicious or fraudulent insurance investigations in all business lines and jurisdictions. Our Contract SIU service components include Anti-Fraud Training, Annual Anti-Fraud Reports, SIU Investigations and Suspicious Claim or Issue Referrals to state DOI’s or law enforcement. Other available SIU services are Anti-Fraud Audits, Data Mining and Vendor Management. These Contract SIU services are provided as a comprehensive program or tailored to your individual needs.

Woodall & Broome recognizes that Anti-Fraud statutes have become complex, and violations can be subject to substantial fines, penalties or denial of a rate increase application. To assist our clients in meeting and exceeding state Anti-Fraud requirements, Woodall & Broome has assembled a team of veteran Anti-Fraud compliance coordinators. Their experience and expertise will assure that you stay in compliance with all regulatory requirements and reduce your costs through savings from efficient management of your SIU program.

ARE YOU ANTI-FRAUD COMPLIANT?

Almost every state currently requires that suspicious claims or issues be reported to regulators, law enforcement or other authorities. Many have very specific forms, regulations and requirements related to Anti-Fraud training, fraud plans, annual reporting and carrier SIU composition. Woodall & Broome can assure that you meet or exceed all regulatory requirements.

 

Woodall & Broome understands the importance of staying on top of all legislative and regulatory changes that affect your fight against fraud. Once you select Woodall & Broome as your Contract SIU provider, we keep your company up to date and your employees following the proper Anti-Fraud procedures from state to state. With Woodall & Broome you never have to worry about being out of compliance with state SIU regulations.

 

ANTI-FRAUD PLAN

Woodall & Broome can prepare a compliant Anti-Fraud plan for each jurisdiction in which your company is licensed to do business. Woodall & Broome can also meet regulatory requirements for your SIU with our adequately staffed, trained and experienced investigators.

 

ANTI-FRAUD REPORTS

Woodall & Broome as your Contract SIU provider will manage the data needed to complete and file applicable state annual compliance reports in a timely manner.

 

ANTI-FRAUD TRAINING

Training for integral staff is required in many states. Woodall & Broome can tailor your Anti-Fraud training to meet all your specific compliance needs for all business lines and jurisdictions. Our Anti-Fraud training can be provided both on-line or on-site by our experienced SIU personnel. We monitor your training and maintain adequate records for DOI audits or reviews as may be required.

 

SIU SURVEYS

As your Contract SIU provider Woodall & Broome can conduct on-site surveys of your claim files and policies to help ensure that you are in compliance with state regulations. Regular SIU reviews are important to ensure that your company’s Anti-Fraud program is properly assisting in detecting and preventing fraud. It also helps encourage staff members to follow the proper Anti-Fraud procedures in handling suspect files and policies.

 

DATABASES

Discovering useful knowledge hidden in huge volumes of raw data represents a formidable task. Woodall & Broome’s Contract SIU can simplify and focus the database needs based upon the insurer specific business profile. Databases can be a tremendous tool to detect and prevent fraud and abuses before they emerge. Most important they can help prevent or diminish losses.

 

VENDOR MANAGEMENT

Proper management of your Anti-Fraud program with all vendors will result in improved reporting, investigation results, stronger relationships with your vendors and better alignment with your expectations. Woodall & Broome’s Vendor Management service is a proven program to help you reduce risk and increase return from your investigative budget.

 

ANTI-FRAUD PROGRAM MANAGEMENT

Woodall & Broome will provide internal reporting to communicate with your management personnel concerning the operations of your Anti-Fraud SIU program. Internal reports can be customized to meet your company’s specific needs and requirements for information. Detecting emerging fraud activity quickly and accurately is an important way of focusing investigative resources where they will provide the greatest financial return. Our status reports will keep your executive managers informed as to the trends, the issues and the successful prosecution of any insurance fraud case filed.

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