FRAUD Policy

FRAUD POLICY

Revision Date
Last modified: November 2, 2021

FRAUD PREVENTION MISSION STATEMENT

Mount Vernon Specialty Insurance and Radnor Specialty Insurance recognize that fraud exists in the insurance industry. As such, it is the policy and mission of the company to strive to detect and prevent insurance fraud through the employment of an effective and diligent Anti-Fraud Plan. As part of the company’s management process, USLI claim staff will endeavor to thoroughly review each claim with the specific goal of identifying those claims exhibiting fraud related indicators, red flag events and situations or behavior indicative of fraud schemes. Those identified will be directed for specialized handling.

ANTI-FRAUD PLAN

The purpose and goal of our Anti-Fraud Plan is to educate, detect, investigate and deter insurance fraud thereby helping to reduce insurance costs.

FRAUD INVESTIGATION AND TRAINING

The companies have a Special Investigations Unit (S.I.U.) that is responsible for the review and disposition of all suspected fraudulent insurance acts. The S.I.U. also provides training to employees and appointed producers in detecting, investigating and referring cases of suspected transactional and claim fraud. If you are interested in assisting our companies in our anti-fraud efforts and would like to receive more information or training on how to detect and handle cases of suspected fraud, please contact one of the members of our S.I.U. listed below.

S.I.U. Review Committee

Lauren Reiley
Executive Vice President, General Counsel, Chief Compliance Officer
1190 Devon Park Drive, Wayne, PA 19087-2191
(610) 225-2224

Jim Scalise
Executive Vice President, Chief Claims Officer
1190 Devon Park Drive, Wayne, PA 19087-2191
(610) 225-2551

SPECIAL INVESTIGATION UNIT (S.I.U.)

The companies have an S.I.U. composed of a three-person Anti-Fraud Review Committee responsible for the review and disposition of all suspected fraudulent insurance acts, a two person Anti-Fraud team responsible for the detection, evaluation, investigation and reporting to state fraud bureaus, and a Legal and Compliance Team to provide assistance in the companies’ anti-fraud efforts.

POSITION

Insurance fraud will not be condoned by our companies. Our personnel are dedicated to the prevention of insurance fraud and will aggressively review, analyze, monitor, investigate and seek prosecution of fraudulent insurance acts to the fullest extent of the law. These acts include but are not limited to: Application Fraud, Certificate of Insurance Fraud, Fraudulent Insurance Claims and the Understating Rating Exposures such as Sales, Payroll, etc. Further, we will comply with state statutes with respect to the reporting, investigation, and preparation of Anti-Fraud Plans.

REPORTING

Suspected fraudulent insurance acts must be reported to the respective State Fraud Bureau where applicable. Those acts involving Mount Vernon Specialty Insurance and Radnor Specialty Insurance should be referred to us using the sample referral form.

Click here REFERRAL FORM

All suspected fraudulent insurance act referrals including supporting documentation should be forwarded to:
Chief Compliance Officer
Devon Park Specialty Insurance
1190 Devon Park Drive, Wayne, PA 19087