Essential to the successful implementation of any effective Fraud Prevention Plan is a committed partner who has an in-depth understanding of the insurance industry and the key elements of a fraud prevention program. We believe that Daniel J. Hannon & Associates, Inc. is that partner.
The New York State Department of Financial Services requires that all insurers writing private or commercial auto insurance, workers’ compensation insurance, or individual, group or blanket accident and health insurance, except for those insurers that write less than 3,000 of such polices in the State annually, must develop and file a plan with the Superintendent for the detection, investigation and prevention of fraudulent activities in the State.
The plan shall include the establishment of a full time Special Investigation Unit separate from the underwriting or claims functions of the insurer. In the alternative, an insurer may contract with a qualified provider to perform all or part of these functions.
At DJH, we strive for severity and expense reduction on a case-by-case basis. Equally important, however, is a governance program that keeps your company in full compliance with Department regulations.
Our SIU staff investigators will be dedicated solely to your investigations in New York State. Every SIU investigator’s qualifications greatly exceed the minimum requirements as set forth by the State. The staff is comprised of former law enforcement investigators, an attorney, a certified fraud examiner, a legal nurse consultant, and individuals who have worked as insurance claims investigators in the private sector for many years.
As your SIU vendor, we will work closely with your company designees to implement a program that will:
- Assist the claim staff in identifying possible fraud
- Gather evidence to substantiate valid claims and reject fraudulent claims
- Identify fraud trends and new schemes
- Heighten underwriting and claim awareness and understanding of fraud through training
- Serve as a liaison between company, Fraud Bureau, and Law Enforcement agencies
- Provide surveillance services when appropriate
- Provide for attendance at trials or hearings
- Assist in recoveries of funds through restitution in criminal cases
If your company is committed to providing its policy holders with premier insurance products at a competitive cost, and is vigilant in its approach to fighting fraud, then Daniel J. Hannon and Associates, Inc. is your logical choice.