All insurance companies have a Special Investigative Unit [SIU] that handles elevated claims. Policyholders may be informed by the claims adjuster that their claim has been transferred to the SIU, leaving the insured confused and perhaps apprehensive. So, what does it mean when a claim has been transferred to the SIU?

A claim is transferred to the SIU when an insurance company believes there could be fraudulent activity in a claim. The SIU will investigate the claim more thoroughly than the normal claims handling process to determine potential fraud. Such investigation may require that the insured participate in an Examination Under Oath, or EUO, much like non-elevated claims.

Some policy holders may find themselves transferred to the SIU if they have retained a public adjuster to assist with handling their claim. However, an insurance company transferring a claim to the SIU solely because of the involvement of a public adjuster violates Florida Administrative Code §69B-220.201(3)(b), which requires that an adjuster treat all claimants equally, and §69B-220.201(3)(q), which states, in part, “no insurer, independent adjuster, or company adjuster shall represent or imply to any claimant that public adjusters are unscrupulous, or that engaging a public adjuster will delay or have other adverse effect upon settlement of a claim.”

If your claim has been transferred to the SIU, don’t panic. However, it is important to know your rights. The Florida Administrative Code requires that insurance companies follow guidelines for the proper and fair handling of claims. If you are unsure why your claim has been transferred to the SIU or you feel you are being treated unfairly, consulting with an attorney may help ensure that your claim is being handled in accordance with the law.