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What is a Special Investigations Unit?


When insurance companies deem a personal injury claim to be suspicious in some way, they are sent to a special investigations unit, or a SIU. What is a special investigations unit? A special investigations unit is essentially an insurance company’s fraud division, which is tasked with investigating any claim sent to it as fraud. The insurance adjustors who work in SIU departments are often former law enforcement personnel, including members of the FBI.

What Types of Cases Go to the SIU?

There are a few common scenarios that significantly increase the chances that a claim will get sent to an insurer’s SIU, including -

  1. The most obvious case is when there are clear indications of the claim being fraudulent.
  2. A claim may also be sent to a SIU if a suspect physician, lawyer, or business is attached to the case. A doctor or lawyer that has a history of taking potentially fraudulent cases being attached to your claim may cause you to end up on a SIU watch list, which will cause all your claims to be investigated for fraud.
  3. A claim may also be sent to a SIU if a suspect business is attached to the case because insurers will consider all businesses attached to your case, such as auto body shops, to check if a history of fraud is present.

All of these possibilities are investigated using fraud-tracking software that follows relationships between clinics, law firms, and auto repair businesses. Most major insurers now belong to national investigations organizations, such as the National Insurance Crime Bureau (NICB), which assists companies in tracking parties engaged in insurance fraud. The NICB has disclosed some of the red flags that may trigger SIU investigations. Unrelated claims that use the language, doctor, or lawyer can become prime candidates to be sent to a SIU department.

What Are the Consequences of a Case Going to the SIU?

Although only about five percent of cases go to an insurer’s SIU, its potential negative effects make it something important to consider. A claim being sent to an SIU can lead to the following consequences, amongst others –

  1. It can affect your ability to get your health care and lost wages paid
  2. It will almost definitely lower any settlement offer
  3. It could cause a non-settled case to drag on for years

Insurers have also been found to offer insurance adjustors incentives to have a certain percentage of claims go to a SIU, so it is crucial that you be prudent in the face of this possibility.

For more information about special investigations units, or for help navigating your particular personal injury claim, contact KI Legal Personal Injury’s experienced team of personal injury attorneys by calling (212) 404-8605 or emailing to set up a free consultation.




This information is the most up to date news available as of the date posted. Please be advised that any information posted on the KI Legal Blog or Social Channels is being supplied for informational purposes only and is subject to change at any time. For more information, and clarity surrounding your individual organization or current situation, contact a member of the KI Legal team.


KI Legal Personal Injury fights for victims of a wide array of personal injury claims, from Motor Vehicle Accidents to Scaffolding and Ladder Falls to Slip/Trip & Falls, amongst others. By leveraging its multidisciplinary foundation and, with the help of its experienced litigators, KI Legal Personal Injury can fight for the results and compensation that victims deserve without pushing for premature settlements due to financial reasons. This financial paradigm shift swings the pendulum in our favor when it comes to negotiating with insurance carriers, inherently leading to better results for clients. For the latest updates.

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