Mercury Insurance’s Special Investigations Unit (SIU), founded in 1978, is the company’s secret weapon against fraudulent insurance claims, which cost the average U.S. family $700 per year in increased premiums.
The goal of the unit, which consists of 40 seasoned investigators in 11 states, is to catch white-collar con artists, shady doctors and lawyers, and even the occasional celebrity who has filed fraudulent claims. Ultimately, the SIU exists to prevent phony payouts and exaggerated claims stemming from staged accidents, arson, auto and identity theft, and padding of medical expenses, to help keep rates low for Mercury policyholders. But that’s not all, because they also provide assistance to law enforcement when requested to help put these criminals behind bars.
Pete Galassi, leader of Mercury’s SIU team, gives insights into Mercury’s SIU while addressing industry trends and what consumers can do to help fight fraud.
Question: What types of insurance fraud does Mercury investigate?
Mercury: Our investigations include auto theft, bodily injury, medical and homeowners fraud, identity theft, and more. Our team utilizes extensive forensic data mining and evidence collection that helps us build a case against these criminals. Mercury’s SIU is seen as experts in the field, and they’re often called upon by state and local law enforcement agencies to help train or assist them in these areas.
Question: Roughly how many claims has Mercury’s SIU had to investigate during the past 40 years?
Mercury: We’ve investigated more than 83,000 claims (based on an annual statistical average) since our team was created in 1978.
Question: What has changed over the four decades the SIU has existed, and what has stayed the same?
Mercury: Criminals looking to take advantage of the system for a fast payout continues today, however, the level of trickiness on their part has become more sophisticated. Now fraudsters have upped their game to include the use of outpatient surgery centers to create files for nonexistent patients or even perform unnecessary surgeries to facilitate payouts. The organizers of these operations have shifted from doctors and attorneys to organized crime rings.
Technology has aided criminals in their insurance fraud tactics, too. The culprits are now armed with high-tech imaging machines that can produce fake medical records, false IDs and business licenses. The claim scenarios stay pretty much the same, but the cleverness of their scams are much more advanced than they were as recent as five years ago.
Question: How have recent advances in technology aided the SIU team’s investigations?
Mercury: Not only has technology helped the bad guys, but it has also helped our investigators. The emergence of social media, investigative tracking tools, link analysis programs and surveillance devices have significantly increased our team’s ability to identify and track criminal activity.
Question: Why should consumers care that Mercury has a SIU team?
Mercury: Mercury Insurance’s Special Investigations Unit (SIU) is the last line of defense against fraudulent insurance claims, which cost the average U.S. family $700 per year in increased premiums. Our goal is to protect our customer and will continue to fight fraudulent or exaggerated claims, which helps keep our rates low.
Question: What’s the most expensive case of fraud the SIU uncovered?
Mercury: In 2007, a group of individuals opened several water restoration companies and began billing for services not rendered and equipment not used. An investigation into these companies showed a pattern of fraudulent activity which led to the filing of a $14 million civil suit in which Mercury was victorious.
Question: What’s the most common type of fraud the SIU team unravels?
Mercury: Medical fraud is the most prevalent type of insurance fraud we investigate, and we don’t see this slowing down in the future.
Question: Are you seeing an increase in certain types of claims SIU has to investigate?
Mercury: Investigating fraudulent homeowners’ claims has become a larger part of our day-to-day operations. We’re looking into a growing number of burglary, water loss and vandalism claims. These are gaining in popularity for individuals looking for a quick payday.
Question: What are some telltale signs consumers should look for to avoid falling victim to a fraud scheme?
Mercury: Our team has the saying: if you’re not looking for fraud, you won’t find it. Consumers who find themselves in a situation that just doesn’t feel right should think critically about what took place. An example is a staged auto accident, where culprits will add damage to vehicles after a loss, switch drivers on accident reports or add additional names of people to the report who weren’t involved. So, always be sure to document people, places and things involved in a car collision. Take photos at the scene of the accident of both the vehicles and people involved, as these can be used to protect you from a fraudulent claim. And if you suspect you’re the victim of insurance fraud or see someone else committing it, you should make your suspicions known when reporting the claim to your insurance company or report it to the National Insurance Crime Bureau.
Source: Mercury Insurance
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