Part I: The Thin Red Line of Fraud Fighters The CASIU Story

The Canadian Association of Special Investigation Units is a low profile organization that fights the good fight against insurance fraud. Staffed from the claims side of the P&C industry by volunteers, it works minor miracles on a thin budget. It is the core of a loose-knit fraud fighting network, and it needs encouragement and support from the big anti-fraud players in terms of encouraging some of their claims and investigative staff to join CASIU and pay the modest membership fee.

In the beginning

The Canadian Association of Special Investigation Units -Trillium Chapter (CASIU) developed as a result of wishing to bring a Canadian identity to the battle against insurance fraud. CASIU became an organization of volunteers from the claims area of the property-casualty insurance industry who cooperated in the fight against fraud.

Although it was acknowledged that insurance fraud had no borders, there was a clear need to concentrate on Canadian issues and develop made-in- Canada solutions. For example, the growing involvement of organized crime in Ontario insurance claims dictated an organized local response to the problem among SIU and claims people. Hence CASIU was born, circa 1998, with the mandate to educate and bring together Canadian personnel involved in the insurance fraud battle.

The first initiative was to educate insurance claims personnel and their partners, such as independent adjusters, on the issues of insurance fraud. The initial meetings were arranged for this purpose, dealing with the hot topic of the day. Since the meetings were held as an open forum, there was the added benefit of allowing the attendees to network, establishing new relationships and bringing new partners into the battle.

It became apparent rather quickly that more in-depth education was required if CASIU was to meet another mandate — namely to promote a greater understanding of the ongoing evolution of insurance fraud. More and more, members were seeing a growing number of professional criminals involved with insurance claims.

CASIU rose to the occasion, and along with the regular scheduled meetings in the early years, began to hold topic specific seminars at various times through out the year. These events dealt with all aspects of fraudulent insurance claims, bringing in guest speakers ranging from police officers/officials, solicitors, vendors, investigative specialists and others, all of whom brought specific anti-fraud skills to the speaker’s podium. Our biggest event became the Annual Toronto Fraud Forum, a joint one-day insurance fraud conference now in its tenth year, co-hosted by our conference partner, the Toronto Chapter of the Association of Certified Fraud Examiners (ACFE).

The seminars proved to be extremely successful. Feedback from the attendees was very positive, especially in terms of being informative and helpful in the actual day-to-day handling of suspicious claims.

In addition to these seminars, CASIU members have participated in various success stories through out the years. They have been asked to assist in investigations being conducted by local police departments, as well as other law enforcement agencies. For example, CASIU has been instrumental in coordinating efforts to secure equipment (such as automobiles) for local police “stings.”

CASIU members have also been requested to speak at numerous industry- related functions, often as head table participants, or key note speakers. In fact the networking aspect of CASIU has been recognized by many outside agencies, who continuously reach out” to us for assistance.

While CASIU is proud of its accomplishments to date, it has also experienced growth pains and has had to deal with these challenges from time to time. For example, currently CASIU has members from many regions of Canada, but only one chapter — the Trillium Chapter — to deal with the entire country. The necessity of having local chapters has not escaped the Board of Directors, and this will be an area of focus.

In conclusion, the greatest challenge at present is the expansion of organized crime in claims fraud, especially in Ontario. CASIU understands that there is an even greater need for training and cooperation to fight these professional criminals. It is a question of numbers. The more individuals and companies combating insurance fraud, the greater the level of success. As in the beginning of our history, CASIU will be there to educate and assist in the future.

Part II: Cooperation Equals Success will be featured in the August/September issue of Claims Canada.