This course explains how insurers comply with state-mandated special investigation unit regulations, including such topics as the regulations themselves, what they impose on the insurer, and how the insurer will fulfill the regulations. 

The course covers the following:

  1. All of the Special Investigation Unit Regulations imposed by – as an example – the California regulations.
  2. The need to train integral anti-fraud personnel in how to recognize potential insurance fraud.
  3. The need to create a special fraud investigation unit.
  4. Training by the special investigation unit.
  5. Training of all claims personnel in recognizing insurance fraud.
  6. How to train claims personnel to recognize the red flags of fraud.
  7. An explanation of the function of an SIU.
  8. The statutes that require a fraud investigation unit or SIU.
  9. An explanation of the Insurance Fraud Prevention Acts.
  10. The immunities provided to fraud investigators.
  11. The red flags of fraud.
Learning Objectives
  • Recognize the many red flags, or indicators, of fraud,
  • Explore why an SIU is required.
  • Recognize the obligation of the insurer to maintain a special fraud investigation unit.
  • Recognize the indicators of fraud that require an SIU investigation.
  • Recognize the statutory immunities provided to insurers who conduct a suspected fraud investigation.
  • Identify the requirement that the SIU train all integral anti-fraud personnel to recognize insurance fraud attempts.
  • Explore the importance of a thorough fraud investigation.
Last updated/reviewed: August 20, 2023
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Included In Certifications

This course is included in the following Certification Programs:

16 CoursesCorporate Property Insurance Certification

  1. Introduction: Excellence in Claims Handling
  2. How to Acquire a First-Party Property Insurance Policy
  3. How to Read and Understand an Insurance Policy
  4. The Necessity of an Honest and Complete Insurance Application
  5. The Basics of the Law of Contracts for the Insurance Professional
  6. Ethics for the Insurance Professional
  7. What is the Problem with Fraud?
  8. Interviewing Techniques for the Insurance Professional
  9. Investigation of a First-Party Property Insurance Claim
  10. The Creation of a Scope, Statement, and Proof of Loss
  11. The Duties of an Insured Presenting a First-Party Property Claim
  12. The Insurance Examination under Oath (EUO)
  13. Insurance Fraud Prevention
  14. Compliance with Special Investigation Unit Regulations
  15. Compliance with Good Faith Settlement Practices Regulations
  16. The Obligations of a Public Insurance Adjuster
1 Review (4 ratings)

Reviews

4
Anonymous Author
The instructor is great and does a great job covering the information. Keep in mind the information is specific to California law.
Prerequisites
Course Complexity: Intermediate

No Advanced Preparation or Prerequisites are needed for this course. However, it is recommended to take the other courses in the series prior to completing this one.

Education Provider Information
Company: Illumeo, Inc., 75 East Santa Clara St., Suite 1215, San Jose, CA 95113
Contact: For more information regarding this course, including complaint and cancellation policies, please contact our offices at (408) 400- 3993 or send an e-mail to .
Instructor for this course
  Course Overview CPE
Course Syllabus
INTRODUCTION AND OVERVIEW
  Introduction to Compliance with Special Investigation Unit Regulations10:31
  Function, Purpose and Procedure of SIU4:29
  Types of Property Insurance Fraud14:15
  CIC Sections 1871, 533; CPC Sections 550, 548; CIC Sections 1871.1 & 1872.48:43
  Insurance Code Sections 1872.4, 1875.2, and 187314:22
  Recognizing False Documents4:44
CONTINUOUS PLAY
  Compliance with Special Investigation Unit Regulations57:07
SUPPORTING MATERIALS
  Slides: Compliance with Special Investigation Unit RegulationsPDF
  Compliance with Special Investigation Unit Regulations GlossaryPDF
REVIEW and TEST
  REVIEW QUESTIONSquiz
 FINAL EXAMexam