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Special Investigations Unit (SIU)

The Insurance Information Institute reports that 10 percent of all insurance claims are fraudulent, costing the U.S. property and casualty industry $30 billion a year.* To help protect our policyholders' interests and keep our premiums to a minimum, CNA's Special Investigations Unit (SIU) diligently detects, pursues and mitigates insurance claims fraud risk.

A Talented Staff
CNA has 24 individuals dedicated to SIU with an average of 25 years of investigation experience in state, local and federal law enforcement, the U.S. military and claim organizations. Our SIU experts are located throughout the country and offer a complete range of services, including coordinating assignments with our fraud, surveillance and data investigation vendors, reporting suspicious claims to state fraud agencies and developing and delivering fraud awareness training. Our SIU team also works closely with our Claim area to identify and investigate suspected fraudulent claims.
  
Outstanding Resources
CNA's investigators provide value-added services by developing national programs to aggressively detect and reduce the impact of fraud. Our SIU team leads the industry in specialized services, identifying new and emerging fraud trends and staying one step ahead of the criminals.

Our resources include the following:
 

  • Major Investigation Team (MIT) provides an enhanced focus on medical-provider fraud, organized crime-ring activity and automobile crimes. MIT efforts resulted in criminal convictions of medical providers, closure of suspect medical clinics and suspension/revocation of a number of medical licenses.
     
  • Predictive Analytics Program is a powerful tool in fighting fraud. Developed in collaboration with SAS®, our predictive modeling program uses advanced statistical data analysis and text mining to identify patterns of aberrant behavior, both in individual claims and on a large scale across multiple files and lines of business.
     
  • Social Network Data Mining is conducted by pulling and analyzing data from multiple sources to reveal associations between claimants and providers, and identify patterns of questionable activity that could go undetected by other means.
     

Proven Results
In 2012, CNA had:
 

  • 20 arrests and 18 criminal convictions for insurance fraud.
     
  • 7,507 SIU-related actions and investigations.
     
  • An elimination or mitigation of the claim in 49 percent of fraud investigations.
     
  • 3,775 cases referred to regulatory or law enforcement agencies.
      

Claim Fraud Reporting Line
To better fight this costly and illegal practice, we have created the CNA Fraud Reporting Claim Line, which makes it easier for our customers and agents to report fraudulent claims. The toll-free hotline (866-262-3116) allows anyone to anonymously report claim fraud that will be investigated by our elite SIU team. Reports of fraud can also be submitted through email at fraud@cna.com.

To learn more about the CNA Claim Fraud Reporting Line or our Special Investigations Unit, please contact Tim Wolfe, Assistant Vice President, Special Investigations Unit, at 480-941-3216.

* The Federal Bureau of Investigations, Reports and Publications, Insurance Fraud.

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