Fraud/SIU (Special Investigative Unit)
Quintairos, Prieto, Wood & Boyer, P.A. utilizes specialized attorneys devoted to representing insurance companies in the investigations, litigation defense and prosecution of potentially fraudulent insurance claims. Attorneys practicing in this area possess investigatory experience in handling suspicious claims or ascertaining whether potential fraudulent behavior on the part of an insured exists.
Our representation in this area includes Automobile (including BI and PIP), Property claims, General Liability, Personal Property claims, Arson, Uninsured Motorist claims, and actions on behalf of insurers against claimants and lay-owners of “medical clinics” in violation of insurance fraud statutes, for acts of theft, common law fraud and illegal and unlicensed practice of medicine.
While most general claims may involve the value of a claim, SIU cases, in contrast, involve allegations of fraud; and require a thorough knowledge of various state fraud statutes, unfair claims practices acts, and bad faith decisional law and statutes, all of which may be implicated in most potentially fraudulent insurance claims. We understand that protecting our clients’ interests during discovery, trial, and the appellate processes is paramount. Often, QPWB is called upon even before litigation in order to monitor the development of underlying potential liability and to analyze and calculate projected exposures in particular losses. QPWB attorneys take a proactive approach to resolving matters efficiently and effectively.
Providing coverage decisions requires decisive recommendations, backed by detailed knowledge of investigatory best practices and fact gathering acumen. With the assistance of specialists and other experts, QPWB is able to analyze specific issues relating to the cause of loss for coverage determinations and scope of damages.
QPWB handles personal injury or casualty claims where injuries are suspect, involving repetitive claimants or contested or fabricated incidents.
- Conduct claim file reviews to ascertain whether a particular claim warrants further investigation.
- Conduct detailed Special Investigative Unit investigations of suspicious claims; including the conducting of examinations under oath, clinic investigations and other investigatory skills to assist in analysis of suspicious fraud schemes, misrepresentations, concealment, and fraud issues.
- Provide Automobile, Property and Liability litigation defense and/or affirmative prosecution of claims.