Special Investigative Unit

The Special Investigative Unit (SIU) Compliance Office inspects insurance companies to ensure compliance with the California law and the California Code of regulations governing the maintenance and operations of the SIUs. These provisions require insurance companies licensed to conduct business in California to have viable SIUs operating within regulatory parameters. There are over 1200 companies licensed to conduct insurance business in California who are subject to these provisions that submit an annual report of their anti-fraud operations and procedures to the SIU Compliance Office. This unit provides an annual report format and evaluates the completeness of the report to the Fraud Division that is submitted annually or biennially by these insurance companies.

During the fiscal year 2001, a series of 19 compliance surveys were conducted to examine insurer operations and ascertain their compliance with SIU law and regulations. Formalized compliance reviews were initiated in November 2001 using procedures developed from the information gathered from these surveys.

The function of the review is to identify areas of regulatory non-compliance and operational weakness, and to provide technical assistance to the insurer SIU personnel. If applicable, a report of findings that articulates any findings of noncompliance and observations for strengthening of the insurers SIU operations is issued to the insurer at the conclusion of the review. In addition, Compliance Office staff has commenced the state rulemaking process to redevelop the current SIU regulations in an effort to clarify, organize and strengthen those regulations. Completion of those regulations is projected for summer of 2003.

For assistance, please contact the Fraud Division Regional Office in your area, or contact the Division Office.