Special Investigation Unit (SIU)
An insurer's in-house team that investigates suspicious claims, relying on its own investigators and on licensed private investigators, within the limits set by privacy law and the rules on fair evidence.
On 22 December 2023, the full assembly of the French Cour de cassation held that evidence obtained unfairly may be produced in a civil trial if it is indispensable to the exercise of the right to evidence and the interference with the other party's rights remains strictly proportionate to the aim pursued. Insurers' special investigation units read the ruling closely, because their job is precisely to produce evidence that the policyholder would rather not see. The unit, which the market usually calls the SIU, receives the files that claims handlers or the fraud score send it, and decides what to dig into. Its means are standard: cross-checking documents, querying authorized industry databases, interviewing the policyholder and witnesses, review by a loss adjuster, and sometimes an outside investigator. In France, that investigator is an agent de recherches privées, a profession governed by book VI of the Internal Security Code, who must hold a license from the CNAPS, the regulator of private security: an approval to run an agency, or a professional card to work for one. Surveillance, photography and neighbourhood inquiries are allowed, but the courts check that the intrusion into private life stays proportionate to the aim, especially when an accident victim is watched at home for weeks to challenge a bodily injury claim. An investigator's report is only one piece of evidence among others, freely assessed. The CNIL, for its part, regulates anti-fraud data processing and the placing of a policyholder on a watch list. Most units measure their effectiveness by the amount of fraud avoided, a flattering figure that is hard to audit. The more serious ones also track the share of files closed with no further action, which shows how many honest policyholders came under suspicion.
A policyholder claims total incapacity after a skiing accident, and the fraud score flags a professional activity declared elsewhere. The unit has a licensed private investigator check that the claimant is working on a building site, with a report confined to public places, and it is that report, filed alongside the medical adviser's opinion, that grounds the challenge.
special investigation unit, siu, insurance fraud investigation unit, insurance investigator, claims investigation unit
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