OUR MISSION
“Our mission at FCI is to be at the forefront of the investigative industry with getting results and being
your partner in fighting fraud. We are a results driven company. We offer cost containment solutions for our
clients. At FCI you can be assured that all of your investigative needs will be met. Our focus will be to
handle your investigative needs from your initial contact to the complete resolution by strong focus on
customer service, investigative expertise and RESULTS.”
SERVICES OFFERED(FCI is a full service investigative company)
SIU RAPID REACTION TEAM AOE/COE Investigations SIU/File Review and DIF Submission EUO Fatality Scene Investigations Statements and Interviews Clinic Investigations Theft & Property
INVESTIGATIVE TEAM Surveillance Neighborhood Canvasses Background Investigations Hospital and Pharmacy Verifications Alive and Well Verifications
AOE/COE INVESTIGATIONS
Combat Fraud on the front end Initiate within 24 Hours Secure statement before they “lawyer
up” Speak with witnesses before they
“disappear” or forget Photograph scene Secure evidence Determine Subrogation Sets up for future surveillance
FILE ANALYSIS
Review of Field Notes Review of Surveillance tapes Review of Doctor Notes Review of Depositions & EUOs Review of Statements Determine if there is proof of intent Determine if further investigation is
needed Determine if any inconsistencies within
the file
DIF SUBMISSION
Write Summary of Analysis Organize File Material Meet with Officer assigned to file Following up Report outcome of submission
626 Compliant
Florida law requires that all licensed insurers and health maintenance organizations establish a special investigative unit and/or file an anti-fraud plan to the Division of Insurance Fraud.
FCI can partner up with your existing SIU team
FCI SIU Provides:
Claim Investigation Services Fraud Detection & Prevention On Site Consultation with Established
Office Hours Fraud Feasibility Analysis & Reviews State Fraud Referrals State Compliance & Reporting Toll Free Fraud Hotline
What FCI does to Build a Successful Fraud Case
Evidence, medical report, video surveillance, documentation
Deposition – key to lock down testimony so that they can’t recant their statement (invaluable tool to use following surveillance or receipt of prior medical complaints & treatment
Organized case to present to the Department of Insurance Fraud – the file “needs to speak for itself” – include First Report of Injury, Transcribed Statements, Medical Records, Depositions
OUR INVESTIGATIVE TEAM
Profile Case Social Media Search Assigned to the field Vary up times Communication between Managers and
Investigators Communication back to the adjuster or
SIU Recommendations
What sets us apart? Investigative Staff Management Better Customer Service Pricing No Sub-Contractors
Investigative Staff We build from the ground up – our
investigators are our product Good pay, benefits, video bonus program =
RESULTS Evaluated on a Metric performance system of
stats and time service Other companies build from marketing – sell,
sell, sell
Management Managers promoted from the field Manage on average only 8 investigators Constant communication with the
investigators Continuously strategizing cases Working smart – varying up times Profiling
Better Customer Service
We deal directly with the adjuster or SIU They get a better feel for their cases No middle man like sub-contractors
Biggest Complaints Home/No Activity – FCI gets information No suggestions or recommendations Lost at light They worked it 6AM to 2PM every day! Not letting adjuster know if case is burned
FCI works budget smarter Don’t eat up budget by sitting the mandatory 4 hours Getting results cuts down on exposure
RATE SCHEDULE
AOE/COE Investigations $75.00 per hour EUO $75.00 per hour Surveillance $560.00 per day Neighborhood Canvasses $200.00 Flat Rate Background Investigations $80.00 SIU/File Review $700.00 DIF Submittal $700.00 Scene Investigations $75.00 per hour Statements and Interviews $75.00 per hour Hospital Verifications $99.00 (up to 24) Pharmacy Verifications $99.00 Clinic Investigations $600.00 Flat Rate per day Alive and Well Verifications $200.00 Flat Rate
No Sub-contractors No “middle-man”
Investigators are managed by our managers
It all goes back to communication
Equipment We have a dedicated Linux based web-
server Our software developers have modified
the Cent-os Linux key components to heighten security
We are behind a double-NAT managed Watch Guard firewall which is hardware based
Capability of sending video & statements electronically
PASS(Partner Access System Solutions)
Secure Access to your cases, files & videos
Assigned log in and password
Staff Multilingual – Spanish, Creole, Arabic,
Portuguese, German, and Hebrew Experienced SIU Team All staff can communicate electronically
through computers and blackberrys State of the art video cameras Digital and micro-cassette dictation
equipment Digital Cameras Inside video equipment Well maintained vehicle
Evidence Evidence is stored in a secured, locked,
climate controlled evidence room in our office
Additionally, evidence is stored electronically
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