As your Contract SIU provider, we conduct on-site audits of your claim files and policies to help ensure that you are in compliance with state regulations. Regular SIU audits are important to ensure that your company's suspect files are being referred and that your employees are following the proper anti-fraud procedures in handling suspect files and policies. Llorente SIU will document the details of your audit activity showing that employees are following proper protocols for referring suspect matters to your SIU. This type of documentation can be an important means of demonstrating compliance in the event of a state SIU Compliance Audit.
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 will 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.