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<div class="center"><img src="https://cdn.shopify.com/s/files/1/0301/3604/1571/files/cover_956e9135-dc74-4170-9f7d-25246355796d.jpg?v=1726351704" alt="You Paid For This by Richard Wickliffe"/></div>
<h1 class="center" id="c3">Chapter One: The SIU</h1>
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<div>Imagine you’re at a neighborhood party. Stan, the nondescript neighbor you never talk to, approaches. Unsure what to say, you attempt, “Hi… Stan. How’s work?”</div>
<div class="indent">“My work?” Stan beams. “I got a great insurance story!” He moves into your space to drone on about his days navigating the rigors of risk management.</div>
<div class="indent">At that point, you either plan to fake a phone call or pray your significant other shouts, “It’s time to heat your casserole.” Anything but being cornered with insurance stories. Is anything more boring than an insurance person talking about their job? After all, it’s a product that’s only used when you’ve experienced a terrible loss—perhaps a car crash, fire, theft, injury, or death. Who wants to dwell on that?</div>
<div class="indent">I’m hoping to change that perception. My decades of combating insurance crimes have revealed a fascinating investigative niche unknown to most of the public. Our cases were filled with creativity, amusement, and sometimes pure evil. And even more significant, the cases financially impacted every one of our lives.</div>
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<div class="indent">For a quarter century, I investigated insurance fraud, based out of Miami—which, as you may or may not know, has had a small fraud problem.</div>
<div class="indent">Former Governor Rick Scott described “Florida’s embarrassing problems” with its insurance system. While describing a $910 million scheme, he coined the term “fraud tax” to describe the financial burden these crimes place on all consumers.<sup><a href="ypft_0054.html#n1-2" id="r1-2">[2]</a></sup></div>
<div class="indent">For the first five years, I investigated a broad range of fraudulent property and injury cases. For the following twenty, I managed diverse teams of insurance investigators for the largest property/casualty insurer in the United States, representing over 9 percent of the market, and a global top-ten carrier based on revenue.</div>
<div class="indent">Not for one moment was the job boring or routine. What other career could possibly lead to dealing with organized crime rings, art and jewelry theft, staged accidents, human trafficking, and faked deaths? We had to investigate without having a badge, a gun, or any real authority. Law enforcement had no duty to help us, though many times our cases intersected. We were the unsung heroes of the company’s SIU (Special Investigation Unit).</div>
<div class="indent">I must pause the swelling orchestra to issue a disclaimer that none of the following statements, narratives, or opinions reflect those of my former company. I will not disclose any confidential or proprietary information or trade secrets or name any specific carrier unless notated, and I have changed the names of parties and companies unless otherwise cited. The described scenarios are all true, and I will discuss how to avoid being a victim of the same crimes in our personal lives.</div>
<div class="indent">So, what is an SIU? It is a division within an insurance company that investigates potentially fraudulent insurance cases. SIUs are at the forefront of the ongoing fight against insurance crimes. Their job is to detect, deter, and pursue actions against fraudulent activities. SIU professionals who investigate insurance crimes are also employed by federal, state, or local law enforcement and anti-fraud organizations such as the NICB (National Insurance Crime Bureau).</div>
<div class="indent">Insurance fraud is probably as old as the carpenters who inflated repair costs after Noah’s flood, but the first formal SIU was established in Massachusetts by Kemper Insurance in 1976.<sup><a href="ypft_0054.html#n1-3" id="r1-3">[3]</a></sup> The primary concern at the time was auto-related fraud. Next, with larger property losses, arson became the focus of most SIU teams. Then came the shift into injury, medical, healthcare, and even organized crime.</div>
<div class="indent">Today, virtually all insurance companies worldwide have established SIU teams to help protect the financial integrity of their businesses. Most states have passed legislation mandating that insurance companies establish SIUs, as well as requiring anti-fraud training, essentially asking the carriers, “So, what are you doing about it?”</div>
<div class="indent">For the state in which I was housed, Florida Statute 626.9891, also known as the Fraudulent Insurance Act, mandated every insurer admitted to the state shall create anti-fraud units to investigate and report fraudulent insurance acts, or contract with a third party to investigate possible fraudulent acts. <sup><a href="ypft_0054.html#n1-4" id="r1-4">[4]</a></sup></div>
<div class="indent">With the creation of SIU teams, carriers needed to staff them with experienced people trained to investigate, take statements, and knock on doors, sometimes in unsavory areas. Therefore, employees couldn’t be easily intimidated and would have to work professionally with attorneys and law enforcement.</div>
<div class="indent">SIU teams also serve as liaisons to law enforcement including local and state police, FBI, fire marshals, Coast Guard, and ATF, as well as attorneys, surveillance experts, forensic analysts, and private investigators. Their relationships with experts in those fields are their greatest assets.</div>
<div class="indent">SIU representatives are not any sort of law enforcement. There are no badges, and they can’t make arrests. They are employees with specialized investigative training who represent the carriers. Many times, fraud is committed by people who aren’t the policyholders, such as medical clinics, unscrupulous attorneys, organized crime rings, body shops, dishonest agents, or our newest class of perpetrator: cybercriminals.</div>
<div class="indent">Regrettably, there’s job security in the field of fraud investigation—and it’s on the rise. According to 2022 data from the Insurance Information Institute<i>,</i> about 75 percent of insurers stated fraud has increased significantly, with an 11-point increase since 2014. <sup><a href="ypft_0054.html#n1-5" id="r1-5">[5]</a></sup></div>
<div class="indent">To keep up, a cottage industry of fraud detection firms has grown at a similar pace. The insurance fraud detection market, an entire industry of fraud analytics, is estimated to be a $912.3 million market in the U.S. alone, expected to grow 13.7 percent from 2019 to 2025.<sup><a href="ypft_0054.html#n1-6" id="r1-6">[6]</a></sup></div>
<div class="indent">Here are some facts to enlighten you on the crisis:</div>
<div class="spacer"></div>
<div class="margin">Right now, you and every one of your family members are paying over $932 per year in increased premiums just to fund insurance fraud. That’s nearly $3,800 for a family of four.<sup><a href="ypft_0054.html#n1-7" id="r1-7">[7]</a></sup></div>
<div class="margin">Fraud occurs in about 10 percent of all property/casualty losses.<sup><a href="ypft_0054.html#n1-8" id="r1-8">[8]</a></sup></div>
<div class="margin">Non-medical insurance fraud is estimated at $45 billion per year. <sup><a href="ypft_0054.html#n1-9" id="r1-9">[9]</a></sup></div>
<div class="spacer"></div>
<div class="indent">In the following chapters, I’ll describe various cases, categorized by type and escalating in severity. Most are cases that our SIU teams or I investigated; others are from our colleagues in the industry.</div>
<div class="indent">I’ll begin with routine burglaries, including “art theft on the high seas.” It’ll escalate into arson for profit, the monstrous acts of some arsonists, and even ritual sacrifices gone wrong. Then we’ll move on to organized crime, including the Russian mob’s varied enterprises. I’ll illustrate boat theft schemes and their use in human trafficking. We’ll shift to the rise of illicit medical clinics. Then we’ll recover sunken cars that contain haunting secrets. I’ll explain how not to fake your death, and I’ll conclude with my team’s role in the terrifying Pain & Gain double murder case (complete with robbery, extortion, and torture). I told you there was never a boring day.</div>
<div class="indent">Bottom line: Greed and opportunity continue to increase insurance crimes. Laws and corporate responsibility have hardened the need for SIU investigators as the schemes grow more creative, complex, brazen, and sometimes deadly.</div>
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<h1 class="center" id="c3">Chapter One: The SIU</h1>
<div class="spacer"></div>
<div class="spacer"></div>
<div>Imagine you’re at a neighborhood party. Stan, the nondescript neighbor you never talk to, approaches. Unsure what to say, you attempt, “Hi… Stan. How’s work?”</div>
<div class="indent">“My work?” Stan beams. “I got a great insurance story!” He moves into your space to drone on about his days navigating the rigors of risk management.</div>
<div class="indent">At that point, you either plan to fake a phone call or pray your significant other shouts, “It’s time to heat your casserole.” Anything but being cornered with insurance stories. Is anything more boring than an insurance person talking about their job? After all, it’s a product that’s only used when you’ve experienced a terrible loss—perhaps a car crash, fire, theft, injury, or death. Who wants to dwell on that?</div>
<div class="indent">I’m hoping to change that perception. My decades of combating insurance crimes have revealed a fascinating investigative niche unknown to most of the public. Our cases were filled with creativity, amusement, and sometimes pure evil. And even more significant, the cases financially impacted every one of our lives.</div>
<div class="spacer"></div>
<div class="indent">For a quarter century, I investigated insurance fraud, based out of Miami—which, as you may or may not know, has had a small fraud problem.</div>
<div class="indent">Former Governor Rick Scott described “Florida’s embarrassing problems” with its insurance system. While describing a $910 million scheme, he coined the term “fraud tax” to describe the financial burden these crimes place on all consumers.<sup><a href="ypft_0054.html#n1-2" id="r1-2">[2]</a></sup></div>
<div class="indent">For the first five years, I investigated a broad range of fraudulent property and injury cases. For the following twenty, I managed diverse teams of insurance investigators for the largest property/casualty insurer in the United States, representing over 9 percent of the market, and a global top-ten carrier based on revenue.</div>
<div class="indent">Not for one moment was the job boring or routine. What other career could possibly lead to dealing with organized crime rings, art and jewelry theft, staged accidents, human trafficking, and faked deaths? We had to investigate without having a badge, a gun, or any real authority. Law enforcement had no duty to help us, though many times our cases intersected. We were the unsung heroes of the company’s SIU (Special Investigation Unit).</div>
<div class="indent">I must pause the swelling orchestra to issue a disclaimer that none of the following statements, narratives, or opinions reflect those of my former company. I will not disclose any confidential or proprietary information or trade secrets or name any specific carrier unless notated, and I have changed the names of parties and companies unless otherwise cited. The described scenarios are all true, and I will discuss how to avoid being a victim of the same crimes in our personal lives.</div>
<div class="indent">So, what is an SIU? It is a division within an insurance company that investigates potentially fraudulent insurance cases. SIUs are at the forefront of the ongoing fight against insurance crimes. Their job is to detect, deter, and pursue actions against fraudulent activities. SIU professionals who investigate insurance crimes are also employed by federal, state, or local law enforcement and anti-fraud organizations such as the NICB (National Insurance Crime Bureau).</div>
<div class="indent">Insurance fraud is probably as old as the carpenters who inflated repair costs after Noah’s flood, but the first formal SIU was established in Massachusetts by Kemper Insurance in 1976.<sup><a href="ypft_0054.html#n1-3" id="r1-3">[3]</a></sup> The primary concern at the time was auto-related fraud. Next, with larger property losses, arson became the focus of most SIU teams. Then came the shift into injury, medical, healthcare, and even organized crime.</div>
<div class="indent">Today, virtually all insurance companies worldwide have established SIU teams to help protect the financial integrity of their businesses. Most states have passed legislation mandating that insurance companies establish SIUs, as well as requiring anti-fraud training, essentially asking the carriers, “So, what are you doing about it?”</div>
<div class="indent">For the state in which I was housed, Florida Statute 626.9891, also known as the Fraudulent Insurance Act, mandated every insurer admitted to the state shall create anti-fraud units to investigate and report fraudulent insurance acts, or contract with a third party to investigate possible fraudulent acts. <sup><a href="ypft_0054.html#n1-4" id="r1-4">[4]</a></sup></div>
<div class="indent">With the creation of SIU teams, carriers needed to staff them with experienced people trained to investigate, take statements, and knock on doors, sometimes in unsavory areas. Therefore, employees couldn’t be easily intimidated and would have to work professionally with attorneys and law enforcement.</div>
<div class="indent">SIU teams also serve as liaisons to law enforcement including local and state police, FBI, fire marshals, Coast Guard, and ATF, as well as attorneys, surveillance experts, forensic analysts, and private investigators. Their relationships with experts in those fields are their greatest assets.</div>
<div class="indent">SIU representatives are not any sort of law enforcement. There are no badges, and they can’t make arrests. They are employees with specialized investigative training who represent the carriers. Many times, fraud is committed by people who aren’t the policyholders, such as medical clinics, unscrupulous attorneys, organized crime rings, body shops, dishonest agents, or our newest class of perpetrator: cybercriminals.</div>
<div class="indent">Regrettably, there’s job security in the field of fraud investigation—and it’s on the rise. According to 2022 data from the Insurance Information Institute<i>,</i> about 75 percent of insurers stated fraud has increased significantly, with an 11-point increase since 2014. <sup><a href="ypft_0054.html#n1-5" id="r1-5">[5]</a></sup></div>
<div class="indent">To keep up, a cottage industry of fraud detection firms has grown at a similar pace. The insurance fraud detection market, an entire industry of fraud analytics, is estimated to be a $912.3 million market in the U.S. alone, expected to grow 13.7 percent from 2019 to 2025.<sup><a href="ypft_0054.html#n1-6" id="r1-6">[6]</a></sup></div>
<div class="indent">Here are some facts to enlighten you on the crisis:</div>
<div class="spacer"></div>
<div class="margin">Right now, you and every one of your family members are paying over $932 per year in increased premiums just to fund insurance fraud. That’s nearly $3,800 for a family of four.<sup><a href="ypft_0054.html#n1-7" id="r1-7">[7]</a></sup></div>
<div class="margin">Fraud occurs in about 10 percent of all property/casualty losses.<sup><a href="ypft_0054.html#n1-8" id="r1-8">[8]</a></sup></div>
<div class="margin">Non-medical insurance fraud is estimated at $45 billion per year. <sup><a href="ypft_0054.html#n1-9" id="r1-9">[9]</a></sup></div>
<div class="spacer"></div>
<div class="indent">In the following chapters, I’ll describe various cases, categorized by type and escalating in severity. Most are cases that our SIU teams or I investigated; others are from our colleagues in the industry.</div>
<div class="indent">I’ll begin with routine burglaries, including “art theft on the high seas.” It’ll escalate into arson for profit, the monstrous acts of some arsonists, and even ritual sacrifices gone wrong. Then we’ll move on to organized crime, including the Russian mob’s varied enterprises. I’ll illustrate boat theft schemes and their use in human trafficking. We’ll shift to the rise of illicit medical clinics. Then we’ll recover sunken cars that contain haunting secrets. I’ll explain how not to fake your death, and I’ll conclude with my team’s role in the terrifying Pain & Gain double murder case (complete with robbery, extortion, and torture). I told you there was never a boring day.</div>
<div class="indent">Bottom line: Greed and opportunity continue to increase insurance crimes. Laws and corporate responsibility have hardened the need for SIU investigators as the schemes grow more creative, complex, brazen, and sometimes deadly.</div>
<div class="spacer"></div>
<div class="spacer"></div>
</body>
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