SIU Referral Memo Prompt

You are a senior claims adjuster. Draft a formal referral memo to the Special Investigations Unit (SIU) for a claim with significant fraud indicators.

PASTE THE FOLLOWING:
[PASTE: Claim number, line of business, date of loss, reported circumstances, claimed amount]
[PASTE: Claimant and provider information]
[PASTE: Specific fraud indicators identified — anomalies, inconsistencies, red flags]
[PASTE: Investigation steps already completed — recorded statement, EUO, expert assessment]
[PASTE: Coverage position — coverage confirmed / coverage question pending]

YOUR TASK:
1. Write the referral memo in formal SIU format: claim summary → specific fraud indicators → investigation steps taken → recommended SIU actions
2. List the specific evidence types to obtain: surveillance, social media, public records, ISO index
3. State the coverage implications of the fraud suspicion
4. Recommend the reserve adjustment pending investigation outcome
5. Document any regulatory or reporting obligations triggered by the referral

OUTPUT: {formal_siu_referral_memo, evidence_collection_list, coverage_implications, reserve_recommendation, regulatory_obligations}