When to Escalate a Suspicious Claim and How to Build a Referral That Investigators Can Actually Use
A referral to the Special Investigation Unit is a serious step, and both premature and delayed referrals carry real costs. Knowing when the threshold has been met, what a well-built referral package contains, and how the adjuster's role changes after the handoff makes the difference between a useful escalation and a wasted one.
Preserving the Benefit of the Doubt While Guarding the Carrier Against Bad Faith Exposure
The overwhelming majority of claims are legitimate, and the people filing them are often having one of the worst weeks of their lives. Staying alert to fraud without punishing honest policyholders is a discipline, and it happens to be the strongest bad faith protection a carrier has.
