New York State Department of Financial Services
Frauds Bureau Annual SIU Report
Instructions on Submission of the Annual SIU Report and Company Management Signoff
The Annual SIU Report should contain data for New York business only
The due date of this report is March 15th.
Filers are not allowed to perform a "partial save" of the data. Once each filer accesses the blank form the filer must complete all applicable fields and then electronically submit the form. Upon submission the filer will receive a Submission ID. Filers may exit prior to submission but no data will be retained.
Previously filed Annual SIU Reports may be edited and resubmitted which will result in a new Submission ID. Edits will not be permitted after May 1.
Each insurer must have a minimum of 2 accounts to complete, submit and signoff on the e-form. Each insurer must have a Trusted Source, a Reviewer - SIU Manager and a Reviewer - Executive. A reviewer may also be a Trusted Source. See Directions for sign off of the e-form by the SIU Manager and Executive, below.
At sign-up for account creation, each individual must identify a "lead
company". All individuals from a given company must use the same company
(insurer name, NAIC No.) as the "lead company" in order to be able to
access the e-submission.
Groups that have both P&C and A&H companies and meet the Section 409 threshold must file separate Annual SIU Reports for the P&C and A&H companies.
Each company that is a member of a group must identify all insurers included in the filing.
After logging into the Department's Portal, click the "My
Applications" Tab, then select Frauds SIU -> Actions -> View (See below):
(Step 1): On Frauds SIU Form, select the appropriate form type: click the "Submit AH Form" Tab for Accident & Health Insurers, or the "Submit PC Form" Tab for Property/Casualty Insurers (see below):
Your Company Group(s) should be displayed on the screen (these are the Company(s)/Group(s) you requested during Application sign-up). A list of affiliated companies will appear once you click on a group name. Select all companies to be included in the current report (see below):
(Step 2): The first of 3 Annual SIU Report forms will appear. See below for the data requirements of the Annual Report.
Instructions on completion of the form grid:
1a. & 1b. - New York policy count, Premiums written
2a. & 2b - Number of claims processed, Dollar amount of claims paid
Include ASO business in columns 3a - 6b
3a. & 3b. Number of suspicious claims detected, Dollar amount of suspicious claims detected
3c. & 3d. Number of claims reviewed by SIU, Number of referrals reviewed by SIU
3e. Number of cases opened by SIU
3f. Number of cases closed by SIU
4a. & 4b. Dollar value of savings. Dollar value of restitution and recoveries.
4c. & 4d. Number of investigated claims closed and not paid. Number of claims closed and partially paid.
5. Number of referrals reported to the Insurance Frauds Bureau.
6a. & 6b. Total cost of SIU. Number of SIU investigators (These columns should be broken down by Insurer (I) and Contractor (C)). Report the total amount only in 6a and 6b.
After all 3 input forms have been completed and reviewed, click "Complete Submission" button to transmit the report. The e-Submission ID will now be displayed (see screen below). Please record this Submission number for future reference.
A Reviewer - SIU Manager and Reviewer - Executive must sign off on the form.
After the form has been completed, the insurer may submit the form. Upon submission of the form, the insurer will receive a "Submission ID". This ID number will allow the insurer to access the form after submission. (If the Submission ID is not retained the filing can be retrieved via query.)
The SIU Manager and Executive responsible for the SIU must sign into the portal. After signing into the portal, click the "My Applications" Tab, then select Frauds SIU -> Actions -> Review Approve Submission (See below):
Enter the Submission ID, Submission Year, Lead Company and Form Type. Click Search (see below):
A list of submissions will appear (usually only one) - The reviewer should click on the appropriate submission to review it and then to approve it