James works for a multi-line insurer. He is responsible for investigating claims that raise suspicion of fraud. He is in the

• A. Legal department
• B. Special Investigation Unit
• C. Claims department
• D. Loss control department

Answer: (B)

Special Investigation Unit is the unit within an insurer that focuses on suspected fraud. This team has investigators trained to detect, investigate, and document potential fraud, often using data analysis, interviews, surveillance, and coordinating with law enforcement when needed. Keeping these investigations separate from ordinary claims processing helps preserve evidence and maintain integrity. That’s why it’s the best fit for someone responsible specifically for examining claims that raise fraud concerns. The other departments perform different roles—Legal handles legal matters and litigation, Claims processes and settles claims, and Loss Control focuses on prevention and risk management for insureds.