South Shore SIU Insurance Fraud Defense Attorneys
McGowan & Associates has a team of skilled attorneys that specialize in assisting and defending insurance companies and their insureds in complex Fraud/SIU matters. Below is a bit about this specialized area of practice:
Insurance fraud occurs when people deceive an insurance company in order to collect money to which they are not entitled. This particular fraud is a crime in all fifty states, and the majority of the states have established fraud bureaus to identify and investigate fraud incidents.
WHAT IS SIU?
Insurance fraud is a crime. Each insurer has an internal division set up to identify and investigate potentially fraudulent claims. Known as the special investigations unit, or “SIU” for short, this team is engaged to assist claims personnel if a claim is determined to be suspicious in nature.
SIU INVESTIGATION AND REPRESENTATION
The attorneys at McGowan & Associates are regularly retained by insurance companies to assist with the investigation of suspicious bodily injury and property insurance claims which the companies suspect contain elements of fraud or misrepresentation and we offer the special investigations unit (SIU) of our insurance company clients with a full range of services from consultations about suspicious claims to the aggressive Insurance Fraud Defense at every stage of a claim, from the initial report of loss to resolution. When necessary, we work with law enforcement toward the prosecution of fraudulent claims.
Insureds and third-party claimants have an obligation to be as honest when an insurance claim is filed. This means telling the whole truth about what happened, what’s been damaged, and what hasn’t been damaged. Familiar with all methods of evaluating, litigating, and resolving suspected claims, McGowan & Associates partners with SIU team members to expose the truth while ensuring that investigations are conducted in a legal manner, to protect the company as well as preserve the facts and evidence with an eye toward trial.
McGowan & Associates assists with the evaluation of suspected fraudulent elements of claims, often by assisting the insurer in exercising its contractual right to conduct Examinations Under Oath in first party claims, or working closely with investigators in third-party claims. This process involves identifying, locating and interviewing witnesses and securing documents from an insured/claimant and various third-parties sources and governmental entities.
As SIU counsel, we also assist our insurance partners in summarizing their risk of exposure and handling matters in the most cost-effective and productive manner possible. In this area of practice, we have a history of favorable results. Our representation covers matters from claims handling and investigation to the analysis of complex coverage issues, advice, and refuting bad faith allegations concerning denial of fraudulent claims. We have represented insurers in hundreds of mediation, arbitration, and trials in state and federal courts.
As part of our practice, we are devoted to the thorough investigation, analysis, and litigation of suspicious claims. We draw upon the skills of our attorneys who are experienced in a wide variety of practice areas, and we have the expertise and ability to provide coverage analysis of dubious claims while identifying and analyzing related non-fraud coverage issues for our clients.
EXPERT ANALYSIS AND AN EFFECTIVE LITIGATION PARTNERSHIP
According to the Insurance Information Institute, insurance fraud is rampant and across the property and casualty insurance industry costs nearly $35 billion per year, comprising close to ten percent of industry losses. One IRMI article suggested that all told, the overall impact of insurance fraud is nearly three times that sum. SIU is critical because every dollar saved from fraud goes to a company’s bottom line. We take pride in serving our clients in combatting fraud and in our SIU results. We specialize in aggressively investigating suspicious claims and representing insurance carriers in those cases. As much as SIU seeks to prosecute fraud, SIU lawsuits often contain allegations of bad faith claims handling against our insurance partners, so our expertise in the area of bad faith defense also greatly assists our clients in the SUI practice area.
Above all, effective SIU representation comes down to experience. The members of our team have handled all manner of fraudulent claims and have learned that often to catch a fox, you need to think like a fox. SUI matters require the ability to recognize and understand the various fact patterns and claims involved in a fraudulent scheme. Our experience in SIU cases covers a broad range of fraud matters involving:
- Material misrepresentations in the application for insurance
- Fraudulently obtained insurance policies and premium ratings
- Fraudulent personal injury accident claims
- Inflated and unreasonable UM/UIM and medical payments claims,
- evaluation of potential fraud involving medical provider billings,
- Staged motor vehicle accidents resulting in injury claims
- “Clown cars” a/k/a passenger stuffing
- Staged Automobile damage
- Automobile theft and burn claims;
- Fraudulent first-party property claims,
- Arson and intentional water damage;
- Burglary and staged thefts
WE ARE HERE TO HELP
The attorneys at McGowan & Associates are recognized by our insurance industry partners for our expertise in fraud investigations, as well as for our access to and rapport with local investigators experienced in arson, origin and cause, theft and commercial insurance fraud. If your SIU Team is in need of support from experienced South Shore attorneys, please do not hesitate to contact us to schedule a consultation. Services that we offer include:
- First and third-party coverage analysis
- Claims handling and administration support;
- Coordinating Origin & Cause Investigations;
- Coordinating with Private Investigators;
- Scene inspections;
- Evidence identification and preservation;
- Document Assembly;
- Coordinating surveillance;
- Coordinating asset checks;
- Social network data mining;
- Examinations under oath;
- Coverage analysis and opinions;
- Sworn Statements;
- Assistance with inter-company insurance disputes;
- Representation in arbitrations and mediations;
- Actions for Declaratory Relief;
- Defense of bad faith allegations and extra-contractual claims;
- Defense of suspected fraudulent bodily injury claims;
- Defense of suspected staged automobile accidents or damage claims, and automobile theft;
- The evaluation, investigation and defense of fraudulent property claims (including arson and theft)
- Insurance industry regulation/compliance
- First and third-party jury and trials