About WSYC Law

Understanding Special Investigations Units

Understanding Special Investigations Units

At WSYC Law in Edmonton, Alberta, our insurance lawyers work with clients to ensure that they get the compensation they deserve for insured losses. Whether you are the victim of a car accident, a break-in, a house fire, or any other kind of disaster, we are here to provide legal advice and help you settle insurance claims. In addition to our legal services with regard to insurance claims and dispute resolution, our insurance attorneys also make sure clients receive fair representation and that their rights are not encroached upon by special investigations units (SIUs), insurance adjusters, and other opposing parties. That being said, here’s what you need to know about SIUs.

What Is A Special Investigations Unit?

SIUs are groups of detectives and/or persons with law enforcement experience who are employed by insurance companies to investigate claimees. The purpose of SIUs is to catch insurance fraud when insurance claims have been made, such as insurance claims that exaggerate an event or contain false information about an accident. This protects insurance companies so they don’t end up making payments to claimees who have made a false insurance claim.

Often, SIUs are able to detect insurance fraud early and involve law enforcement to catch claimees who have committed insurance fraud, saving insurance companies millions of dollars every year. In fact, the Coalition Against Insurance Fraud estimates that insurance fraud amounts to more than $80 billion per year across all types of insurance. With insurance companies losing so much money every year, it’s no wonder why many of them choose to hire a SIU onto their staff.

What Is Insurance Fraud?

As previously mentioned, insurance fraud refers to a person submitting a false or exaggerated insurance claim. Some of the most common instances of insurance fraud are exaggerated medical bills and injuries from car accidents, as well as staged accidents. Other common instances of insurance fraud involve making insurance claims for accidents that never happened, such as vehicle theft, break-ins, and collisions. In these cases, the claimee is simply trying to get a payout from their insurance company, which is punishable by law and may have dire consequences (hefty fines and jail time).

According to the Insurance Bureau of Canada, there are two main types of insurance fraud: opportunistic insurance fraud and premeditated insurance fraud. Opportunistic fraud refers to an instance where the victim of an accident takes advantage of the situation and makes an inflated insurance claim. Some examples of opportunistic fraud include reporting damage to a vehicle that occurred before or after a car accident, exaggerating injuries obtained in an accident, and inflating medical expenses, recovery time, and medical needs, like physical therapy. Opportunistic insurance fraud can even go so far as to involve claimees encouraging others to assist in fraudulent activity (such as witnesses and medical professionals), or individuals telling inaccurate stories about what happened during a house fire, auto accident, theft, or any other accident.

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Premeditated insurance fraud, on the other hand, refers to insurance fraud that was planned ahead of time. This kind of insurance fraud takes many different forms, whether that be staging a vehicle accident with unsuspecting drivers or a willing participant, submitting an insurance claim for a made-up accident, or intentionally causing damage to your own property in the hope of receiving compensation. Often, perpetrators of premeditated insurance fraud falsely report things that have gone missing in a “theft” or “break-in,” even if no such thing occurred. Other cases of this type of insurance fraud involve finding ways around insurance premiums by misreporting current residency or not reporting primary vehicle drivers on the insurance policy.

The Problem With SIUs

While SIUs have a distinct purpose in preventing and detecting insurance fraud, this can make the situation worse for victims of real crimes and accidents. Often, claim holders feel as though they are being wrongfully investigated so that their insurance company can find a way around paying for the insured loss. SIU investigators can also make the claimee feel like a criminal for trying to get the compensation they deserve, even if they have done nothing wrong. Sounds scary, right? Not if you have an insurance lawyer to help you navigate the insurance claims process.

At WSYC Law, our insurance attorneys help victims get fair compensation for insured losses in the event of a car accident, theft, break-in, house fire, or natural disaster. Our years of legal experience have given us a keen perspective on settling insurance claims, even when SIUs get involved. If you have been the victim of an accident or crime in the Edmonton area and need an insurance attorney to help settle your claim, we’ve got you covered.

Contact WSYC Law today for assistance settling an insurance claim in Alberta, or feel free to give us a call with any questions regarding insurance fraud and SIUs. We look forward to meeting you and helping you get the compensation you deserve for your insured losses!