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Special Investigations Unit

According to the Coalition Against Insurance Fraud, each year, fraud is estimated to have an impact of nearly $34 billion on the Property and Casualty insurance industry. What’s more, fraud can account for 5-10 percent of claim costs.1

Why Zurich?
When it comes to combating insurance fraud, Zurich employs a series of proactive and responsive strategies aimed at identifying even the most sophisticated schemes.

Our Special Investigations Unit is at the core of all Zurich insurance fraud-fighting initiatives and is continuously taking action to help protect our customers. Services provided by the Special Investigations Unit (SIU) are available to policyholders as part of their policy with us.

We are a resource for you.

Experienced, local specialists

Our nationally distributed, on-staff field investigators and network of specialists are equipped to identify and pursue fraudulent activity across various lines of insurance business.

Zurich professionals average 25 years of experience, including backgrounds in:

  • Claims handling
  • Law enforcement
  • Military
  • Special investigations

Areas of specialization include:

  • Bodily injury
  • Heavy equipment theft
  • Incendiary fires
  • Medical provider referral schemes
  • Medical provider billing practices
  • Organized ring activity
  • Staged accidents
  • Vehicle theft
  • Vehicle finance fraud

Proactive and extensive identification strategies

The Special Investigations Unit is committed to keeping our fingers on the pulse of the latest trends and fraud-fighting technologies. But we don’t keep this information to ourselves. We continuously share insights across the organization so that Zurich professionals are even better positioned to identify and respond to the latest fraud schemes.

Strategic applications of data include:

  • Fraud link analyses
  • Fraud scoring/predictive models
  • Text mining of unstructured data
  • Mobile device and vehicle infotainment forensics
  • Flagging of medical provider outliers
  • Medical provider network analyses
  • Deep dives into online databases

Thorough, collaborative claim investigations

We don’t run our investigations off a checklist.  Our team evaluates and develops execution plans based on the unique circumstances of each investigation. In 2018, Zurich SIU investigated 4,400 cases, which resulted in more than 800 referrals to outside agencies.

Zurich SIU’s work may involve:

  • Compliance/audits
  • Criminal prosecution
  • Impact analyses
  • Mobile device and vehicle infotainment forensics
  • Recovery of fraudulent payments
  • Surveillance

In collaboration with:

  • Zurich insureds
  • Local, state and federal law enforcement
  • National Insurance Crime Bureau (NICB)
  • State insurance fraud bureaus
  • Robust network of service specialists

Customer and broker education

One way to help eliminate losses associated with fraudulent activity is to stop it before it happens. As such, we are focused on proactively arming our customers with information that may help prevent and reduce costs before a loss occurs.

In 2018, we delivered more than 20 training and educational sessions to more than 500 customers and brokers.
Key issues explored:

  • Mobile device and vehicle infotainment forensics
  • Vehicle theft and finance fraud
  • Medical provider network analyses and fraud trends
  • Red flags by line of business

Coalition Against Insurance Fraud. “By the numbers: fraud statistics.” Accessed 21 February 2019.