SIU Investigator Time Consumed by Low‑Value Cases and Manual Tasks

For a medium-to-large carrier, opportunity cost and excess loss exposure from under‑worked complex fraud (organized rings, staged losses, collusive providers) can easily exceed $2M–$10M+ per year in avoidable fraudulent payouts and missed recoveries, while the manual workload also inflates SIU labor costs by hundreds of thousands annually. • For medium-to-large carriers, opportunity cost typically reaches $2M–$10M+ per year in missed or delayed fraud recoveries and prevented losses due to under-worked complex schemes, compounded by 10–30% productivity drag on expensive SIU headcount (often $100K–$150K fully loaded per investigator) being diverted to low-dollar or non-fraud workloads.

Investigators and related staff manually pull data from disparate core systems, emails, spreadsheets, public records, and partner portals; maintain ad hoc case and lead lists in Excel; track follow-ups in email or personal to-do lists; and coordinate with producers, MGAs, reinsurers, and regulators via email, shared drives, and occasional messaging apps instead of a unified fraud workbench and automated triage. • Investigators and supporting staff manually triage referrals, gather data, and work many low-dollar or non-fraud complaints using email, spreadsheets, shared drives, and ad hoc notes instead of an integrated fraud analytics and case management platform with automated prioritization.