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Investigating Fraudulent Claims: The Role of SIU
Previously we have addressed the issues of fraud at the inception of an insurance claim, a carrier's analysis of fraudulent claims and the use of forensic experts to investigate and defend claims. This article will focus on the role of the carrier's Special Investigation Unit (“SIU”) in investigating and defending against fraudulent insurance claims and the role of SIU counsel in the investigative process.
Introduction
Each year, insurance carriers lose millions of dollars as a result of fraudulent insurance claims. In some instances, these claims are the result of individuals submitting fraudulent or inflated individual claims. But an increasingly costly trend is the submission of claims by organized rings involving both hired laypersons and sophisticated professionals. These rings employ schemes that become more sophisticated each year and involve the participation of lawyers, doctors, chiropractors and other licensed professionals. In some instances, even producers and/or insurance company employees are involved in these schemes. In an economy and environment where policyholders routinely seek premium reductions or where carriers have to petition regulatory agencies for premium increases, the failure to adequately investigate and defend against fraudulent insurance claims will adversely affect the carrier in significant ways.
Major Differences In UK, U.S. Copyright Laws
This article highlights how copyright law in the United Kingdom differs from U.S. copyright law, and points out differences that may be crucial to entertainment and media businesses familiar with U.S law that are interested in operating in the United Kingdom or under UK law. The article also briefly addresses contrasts in UK and U.S. trademark law.
The Article 8 Opt In
The Article 8 opt-in election adds an additional layer of complexity to the already labyrinthine rules governing perfection of security interests under the UCC. A lender that is unaware of the nuances created by the opt in (may find its security interest vulnerable to being primed by another party that has taken steps to perfect in a superior manner under the circumstances.
Strategy vs. Tactics: Two Sides of a Difficult Coin
With each successive large-scale cyber attack, it is slowly becoming clear that ransomware attacks are targeting the critical infrastructure of the most powerful country on the planet. Understanding the strategy, and tactics of our opponents, as well as the strategy and the tactics we implement as a response are vital to victory.
Legal Possession: What Does It Mean?
Possession of real property is a matter of physical fact. Having the right or legal entitlement to possession is not "possession," possession is "the fact of having or holding property in one's power." That power means having physical dominion and control over the property.
The Stranger to the Deed Rule
In 1987, a unanimous Court of Appeals reaffirmed the vitality of the "stranger to the deed" rule, which holds that if a grantor executes a deed to a grantee purporting to create an easement in a third party, the easement is invalid. Daniello v. Wagner, decided by the Second Department on November 29th, makes it clear that not all grantors (or their lawyers) have received the Court of Appeals' message, suggesting that the rule needs re-examination.