Texas insurers maintain Special Investigation Units (SIUs) to flag and investigate suspicious claims. Honest claims sometimes get flagged too — the trigger is statistical, not personal.
What triggers investigation
- Late notice (filing days or weeks after a crash)
- Coverage purchased shortly before the loss
- Multiple claims in a short window
- Inconsistencies between statements, police report, and photos
- Suspicious crash patterns (staged accidents, low-impact high-injury claims)
- Out-of-state shop or provider
What to expect
Extended timelines, requests for additional documentation, recorded statements under oath (Examination Under Oath or EUO), and possible referral to law enforcement if fraud is confirmed.
Your rights
- Right to representation during EUO
- Right to copies of your own statements
- Right to a written explanation of any denial
- Right to file a TDI complaint if treated unfairly
Protecting yourself
File claims promptly, document thoroughly, keep records, and be precise in every statement. If you're flagged for investigation, hire a Texas insurance attorney before the EUO.
Frequently asked questions
Why is my claim being investigated?
SIU triggers are statistical, not necessarily personal. Late notice, new coverage, and inconsistencies are common flags.
What is an Examination Under Oath?
A formal recorded interview under oath. Failing to attend can void coverage.
Should I have an attorney for EUO?
Strongly recommended, especially if denial seems likely.
Can the insurer deny based on suspicion alone?
No — they need facts. But they can delay while investigating.
What if I'm accused of fraud and innocent?
Get an attorney immediately. Fight the denial through TDI complaint, demand letter, and suit if necessary.
This article is for general information only and is not legal or tax advice. For guidance specific to your situation, talk to a licensed Texas insurance agent. Ready to put it into practice? Get a free quote or request a policy review.