SIU: The Special Investigation Unit App I Built to Track Insurance Fraud

Summary

After I left the Marines, I went to work at Pringle, Quinn, Anzano in Belmar, New Jersey, from 2004 to 2010 as a software developer. The firm was best known for representing the Special Investigation Units of insurance carriers, including Allstate New Jersey Insurance Company, Encompass Insurance, Mercury Insurance Group and Selective Insurance Company of America, in challenging complex healthcare insurance fraud schemes. SIU was one of the systems I built to help them do it.

The Firm and the Fight Against Insurance Fraud

Pringle, Quinn, Anzano had offices in Belmar, Morristown, Mount Laurel and Trenton. Its practice covered commercial litigation, governmental relations and regulatory law, municipal law, commercial transactions, real estate and land use, and wills and estates. The part of the practice I worked in was insurance fraud. Those cases involved automobile accident fraud rings, healthcare provider fraud, No Fault PIP, UM and UIM claims, and automobile theft claims.

Cases like that live and die on information. Who is connected to whom, which claims keep showing up, which names come back again and again. That information had to be captured, organized and easy to find for the people building the cases.

SIU: Special Investigation Unit

One of the applications I built at the firm was called SIU, short for Special Investigation Unit, the same name the insurance carriers used for their own fraud teams. SIU tracked the people who were under investigation or on the firm's radar for insurance fraud, and it made connections between the different players in each case.

• Business entities: the businesses each person was tied to
• Vehicles: vehicles being followed by private investigators
• Locations: places where people were spotted

Putting all of that in one system is what made the connections visible. People who claimed not to know each other were showing up at each other's businesses. On paper they were strangers. In the data, the links were right there.

Those hidden ties were the whole game. One of the clearest examples came from another system I built, Tag: two men who supposedly had no connection turned out to be linked by a wedding gift of several hundred thousand dollars from one to the other's son, which pointed to a payoff. I tell that full story in Following the Money: Building Tag to Track Insurance Fraud.

SIU was one of several custom systems I built and maintained there to identify and track insurance and healthcare fraud. Lawyers, paralegals and client staff all used them to help litigate complex fraud matters.

What the Job Covered

I owned three things: web application development, database administration and data analysis. I wrote the applications, ran the databases behind them and dug into the data to find what mattered. That mix carried straight over from my time in the Marines, where I built web applications and relational databases for the Marine Corps Logistics Command.

What It Taught Me

Building software for a legal team taught me that the users are the experts. Lawyers and investigators know their cases. My job was to give them tools that fit how they already worked and to keep the data accurate, because in litigation a wrong record is worse than no record. I still build that way: start with the people who will use the system every day and make the data trustworthy.

The Other Systems I Built There

• AutoArb, the automated workflow system for PIP arbitration litigation
• Tag, the system that turned boxes of subpoenaed checks into a searchable database
• The technologies and experience behind all three systems

In My Words

Seeing SIU show people who swore they were strangers turning up at each other's businesses taught me that the truth in a fraud case is usually hiding in the connections.

Brian Messenlehner

Project leadership by Brian Messenlehner.

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