Evidence chain of custody, SIU compliance, fraud signal documentation, and claims leakage prevention — written for TPAs, adjusters, and SIU directors.
Most TPA evidence logs fail in litigation not because the evidence is bad — but because the documentation trail is incomplete. Here's the structured approach that survives judicial scrutiny.
Twelve states mandate SIU referrals for specific claim types. Non-compliant filings get returned — delaying fraud escalation and creating regulatory exposure. This is the definitive guide.
Pattern fraud costs the WC industry $34 billion annually. Most of it passes through undetected because adjusters aren't systematically capturing signals. Here are the 47 you need to know.
Industry estimates put claims leakage at 10–15% of total claims paid. For a TPA processing $10M annually, that's $1–1.5M walking out the door. Here's where it comes from and how to stop it.
When opposing counsel challenges your evidence, can you prove an unbroken chain of custody from collection to court? This step-by-step guide shows exactly what's required.
A well-run SIU delivers 2.5–6x ROI annually. Most TPAs can't measure theirs because they're tracking the wrong metrics. Here are the 7 KPIs that actually matter.
