03 · Insurance & Claim Fraud

When a Claim Doesn't Add Up

"Disabled" but up on a roof. A staged accident. An address nobody actually lives at.

A large share of investigative work never touches a personal relationship at all — it's carriers and employers trying to confirm whether a claim is real. A workers'-comp claimant who says they can't lift a bag of groceries but spends the weekend re-shingling a roof. A staged or exaggerated accident. Questions about whether someone actually lives where the policy says. This is the world of the Special Investigations Unit (SIU), and the repeat buyer is a company, not an individual — which is exactly why insurance and finance show up so heavily in private-investigator employment numbers.

The work is methodical and documentation-driven, because the end product usually has to survive a claims dispute, a hearing, or a courtroom. The point isn't to "catch" anyone — it's to establish, on the record, what a claimant can actually do and where they actually are.

Who needs this?

Insurance carriers and their SIU teams, self-insured employers, workers'-comp and disability administrators, and defense attorneys handling claims.

What it usually involves

Handling a questionable claim?

The next step is a licensed investigator experienced in claims and SIU work. A directory to match you with one is on the way — here's how engagements typically work.

What to expect →

Any professional you choose confirms their license, scope, and fee before any work begins.