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Are you prepared for an SIU Compliance Audit by the Department of Insurance in your state?

Some states conduct audits for SIU Compliance, and some don't. If you are writing business in any state with an active SIU Compliance Unit, you should be prepared for an examination of your anti-fraud plans and procedures. Llorente SIU can help. We have prepared a report listing those states with active SIU Compliance Units, along with some helpful hints for passing state audits. To receive a copy of this report, fill out the form to the right, and sign up for our report entitled State SIU Compliance Audits: What to Expect, and Where to Expect Them.

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State SIU Compliance Audits

Is your company ready for a state SIU Compliance Audit? In order to be sure, we can conduct an onsite audit of your claim files to determine whether suspect files are being identified and referred to the company's special investigations unit correctly. Some states require your company to implement a detailed Fraud Plan and document the details showing how your employees are following the plan's guidelines for suspect case referrals to your SIU. We can ensure that your plan has been properly implemented, and that it is being followed correctly.

Our audits can also help determine whether the evidence exists in a particular claim to prepare a case package as a criminal referral to law enforcement for the prosecution of insurance fraud. When a claim file is lacking in evidence, we will give your personnel a list of additional evidence that should be obtained and an action plan for obtaining that evidence. Llorente SIU can continue to monitor each claim file as the evidence is documented. When the case is ready to be prosecuted, we will prepare the documented referral to law enforcement. We track all criminal cases through conviction, sentencing and restitution.

Insurance companies have a lot at stake during a State SIU Compliance Audit. Many states slap heavy fines on insurance companies for non-compliance with state regulations and can even restrict or forbid an insurance company from writing policies in that state. When you contract your SIU services with Llorente SIU, it is our program that is being audited and we answer to the state's Department of Insurance Fraud Division for you. We have been through state audits in the past and have always passed them successfully.