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Responsibility of the SIU Compliance Office  

https://zalma.com/blog

The primary responsibility of the Special Investigative Unit (SIU)  Compliance Review Office is to inspect insurance companies to ensure  regulatory compliance with regard to the establishment, staffing and  operation of the insurer\'s SIU. 

The Office also is responsible for  updating, distributing, reviewing, monitoring and tracking the annual  SIU compliance reports filed by over 1,100 insurance companies each  year.  The SIU Regulations also requires each insurance company to submit an  annual compliance report to the Fraud Division, SIU Compliance Review  Office. 

The SIU annual reports must provide adequate information and  documentation regarding the insurer\'s anti-fraud operations, policies  and procedures, and anti-fraud training. The SIU Compliance Review  Office provides the format and instruction for submission of the reports  and reviews, monitors and evaluates the completeness and timeliness of  the reports filed annually. After completion of a review and evaluation  of the insurers\' reports filed annually, the SIU Compliance Review  Office considers various risk-based criteria for proper selection of  insurers for SIU review.  Once an SIU compliance review is completed, a preliminary report (or  Exit Review Report) is issued to the company identifying proposed  findings and recommendations. The Insurer is given 30 days to respond  and provide supporting documents and information, after which a Final  Report of Findings (final report) is issued to the Insurer. The final  report may show that all findings have been resolved and the company is  in compliance with the SIU regulations, or that all or some of the  findings still stand and the insurer is subject to legal action  including fines/penalties.  The CDOI provides on its web site a video training program explaining  the California Special Investigative Unit Requirements at http://www.insurance.ca.gov/0300-fraud/0100-fraud-division-overview/12-siu/SIU-video.cfm  which can assist insurers and the integral anti-fraud personnel in  understanding the SIU Regulations and its requirements.  

\\xa9 2021 \\u2013 Barry Zalma Barry Zalma, Esq., CFE, now limits his practice to  service as an insurance consultant specializing in insurance coverage,  insurance claims handling, insurance bad faith and insurance fraud  almost equally for insurers and policyholders.