TIER 2 SECTOR COVERAGE

Insurance

Volume XV of the Sector Coverage Series

For insurance carrier general counsel, SIU directors, claims-fraud investigators, and independent investigators retained by carriers, brokers, MGAs, and coverage-defense counsel.

TIER Tier 2 · Professional Reference
PRICE $227 / monthly
COVERAGE 139 investigative playbooks across 26 categories
DELIVERY Secure dispatch within 24–36 hrs

Professional Reference Material

These playbooks are professional reference material intended for licensed investigators. They are not legal advice. Investigators are responsible for compliance with the laws of their jurisdiction and the specific requirements of their clients and cases.

PROPRIETARY FRAMEWORK

The TALON Difference

Every playbook in this platform is built against TALON, the proprietary defensive-operations doctrine developed inside The Investigator's Desk over years of federal investigative practice.

01

Actor-model analysis

02

Reverse trace

03

Artifact mapping

04

evidence econstruction

“Subscribers receive the playbook; the proprietary model that produced it stays inside the platform.”

TALON Doctrine Secured

Insurance, At a Glance

139

Investigative Playbooks

26

Categories

$227

Per Month

within 24-36h

Dispatch

FULL PLAYBOOK LISTING

The 139 Insurance Playbooks

The full catalog is listed below by category. Each entry is a standalone playbook covering the case type named.

  • 01. Property Claim Fraud

    • Arson-for-profit residential

    • Arson-for-profit commercial

    • Staged burglary and theft loss

    • Vandalism padding and self-inflicted damage

    • Water damage staging and pipe-burst timing

    • Roof damage inflation post-storm

  • 02. Auto Claim Fraud

    • Staged collision rings

    • Owner give-up (vehicle dumping)

    • Phantom passenger claims

    • Medical mill and PIP fraud

    • Repair shop upcharge and phantom repair

    • Total-loss valuation manipulation

  • 03. Workers' Compensation Fraud

    • Claimant malingering and exaggerated disability

    • Off-work activity documentation

    • Provider treatment inflation

    • Employer premium fraud (misclassification)

    • Ghost employee and premium avoidance

    • Applicant attorney and cappers network

  • 04. Life and Disability Fraud

    • Contestable-period application fraud

    • Faked death and pseudocide

    • Murder-for-insurance investigation

    • Disability claimant surveillance

    • Own-occupation vs any-occupation disability disputes

    • STD/LTD claim overlap and stacking

  • 05. Health Insurance Fraud

    • Provider billing and upcoding investigation (carrier SIU)

    • Phantom-patient and identity billing workup (carrier SIU)

    • Pharmacy dispensing fraud workup (carrier SIU)

    • DME fraud workup (carrier SIU)

    • Genetic and lab test kickbacks

    • Subscriber and enrollee fraud

  • 06. Marine and Cargo Claims

    • Cargo theft claim fraud

    • Vessel scuttling and hull loss

    • Cargo damage padding and concealed pre-loss

    • Wet vs dry damage disputes

    • General average investigation

    • P&I claim workup for personal injury at sea

  • 07. Aviation Claims

    • Hull loss investigation

    • Liability and passenger injury

    • Product liability against manufacturers

    • Cargo claim on air freight

    • Warranty vs coverage disputes

  • 08. Cyber Insurance Claims

    • Ransomware claim investigation

    • BEC and social engineering claim

    • Data breach notification and defense cost

    • Extortion coverage triggers

    • System failure vs cyber incident distinction

    • Silent cyber and non-affirmative coverage disputes

  • 09. Directors and Officers Claims

    • Securities class action investigation

    • Derivative action and side-A exposure

    • Regulatory investigation coverage

    • Bankruptcy and side-A carve-out

    • M&A representations and warranties investigation

  • 10. Errors and Omissions Claims

    • Lawyer malpractice

    • Accountant malpractice

    • Real estate agent E&O

    • Insurance agent/broker E&O

    • Architect and engineer E&O

    • Consultant and management advisor E&O

  • 11. General Liability and Premises Claims

    • Slip and fall investigation

    • Trip and fall investigation

    • Assault and negligent security claim

    • Dram shop and liquor liability

    • Dog bite and animal liability

    • Recreational premises injury

  • 12. Product Liability Claims

    • Consumer product injury investigation

    • Pharmaceutical product liability

    • Medical device product liability

    • Automotive component liability

    • Industrial machinery injury

  • 13. Environmental and Pollution Claims

    • Sudden and accidental release investigation

    • Historic contamination and legacy exposure

    • Mold and indoor air quality claims

    • Underground storage tank release

    • PFAS and emerging contaminant claims

  • 14. Construction Defect Claims

    • Multi-family and condominium defect

    • Single-family residential defect

    • Commercial construction defect

    • Water intrusion and building envelope failure

    • Structural defect and code violation

    • Wildfire loss and defensible-space claims

  • 15. Subrogation Investigation

    • Product-liability subrogation

    • Contractor and workmanship subrogation

    • Utility subrogation for fire origin

    • Auto-vs-auto subrogation with liability disputes

    • Property vs auto subrogation

    • Workers' comp subrogation against third parties

  • 16. Bad Faith and Extra-Contractual Investigation

    • First-party bad faith defense

    • Third-party bad faith and Cumis counsel

    • Time-limited demand and settlement setup

    • Excess vs primary carrier disputes

    • Claims-handling audit for regulatory response

  • 17. Coverage and Rescission Investigation

    • Application misrepresentation and rescission workup

    • Late notice and prejudice analysis

    • Cooperation-clause breach investigation

    • Coverage-trigger disputes (occurrence vs claims-made)

    • Named-insured and additional-insured disputes

  • 18. Special Investigations Unit (SIU) Core Cases

    • Ring-fraud investigation with organized network

    • NICB and industry data-sharing coordination

    • Examination under oath (EUO) preparation and execution

    • Undercover claim testing and pretext

    • Confidential informant handling in claim fraud

    • Referral to law enforcement and prosecution support

  • 19. Catastrophic Loss Investigation

    • Hurricane and named-storm claim workup

    • Wildfire loss investigation

    • Earthquake claim investigation

    • Flood claim (NFIP coordination)

    • Winter storm and freeze loss

    • Tornado and hail catastrophe workup

  • 20. Reinsurance and Treaty Investigation

    • Follow-the-fortunes disputes

    • Aggregation and clash coverage disputes

    • Retrocession and spiral analysis

    • Bordereau audit and premium reconciliation

  • 21. Surety and Fidelity Claims

    • Contract bond default investigation

    • Commercial crime and employee dishonesty

    • ERISA fidelity bond claims

    • Financial institution bond (FIB)

    • Kidnap, ransom, and extortion claim

  • 22. Title Insurance Claims

    • Forgery and impersonation claim

    • Undisclosed lien and encumbrance

    • Boundary and survey dispute

    • Access and easement disputes

  • 23. Warranty and Extended Service Contract Claims

    • Home warranty fraud

    • Auto extended service contract fraud

    • Consumer electronics warranty fraud

    • Commercial equipment warranty fraud

  • 24. Specialty and Program Business

    • Trucking and commercial auto SIU

    • Contractor liability program claim workup

    • Habitational and REIT program claims

    • Public entity liability claims

    • Nonprofit and social service program claims

  • 25. Insurtech and Digital-Claim Exposure

    • App-based and telematics-fraud investigation

    • Photo and video claim manipulation

    • Automated adjudication error and defense

    • Embedded insurance and marketplace fraud

  • 26. Regulatory and Market Conduct

    • DOI complaint response and file audit

    • Antifraud plan compliance and reporting

    • Market conduct examination workup

    • Rate and form filing workup

    • NAIC data call and reporting workup

ADJACENT COVERAGE

Where Insurance Meets the Rest of the Catalog

Insurance investigations regularly cross into adjacent sectors. The volumes listed below carry the framework and playbooks that most often surface alongside an insurance matter. Tier 2 subscribers have access to every volume; the cross-references identify where to look first.

Volume I · Retail

Retail crime and theft claims, business-interruption after retail incidents, product-liability recoveries.

Volume VII · Healthcare

Medical-provider fraud, workers-compensation medical fraud, health-plan matters.

Volume VIII · Construction

Builders-risk claims, construction-defect claims, surety-bond investigations.

Volume XIX · Real Estate

Title E&O, developer builders-risk, mortgage impairment, cyber-coverage tender.

Volume XXVI · Estate and Probate

Life-insurance beneficiary disputes, trust-owned life-insurance matters.

Volume XXIX · Fashion

Luxury-goods and jewelry claims, transit-loss investigations, provenance-based recovery.

SUBSCRIBER ACCESS AND DELIVERY

What Ships & How

Two Documents Per Case Request

Operational Playbook

The doctrinal chapter: case overview, business and practice framework, investigative blueprint with step cards covering purpose, actions, output, restrictions, and gates, evidence considerations, interview strategy, report considerations, common mistakes, a tabletop exercise with worked answers, closing take, and the case-specific Client Communication Pack of email templates for every touchpoint from proposal through invoicing.

TALON Brief

The actor model for the case typology, the artifact map, and the reverse-trace sequence. This is the doctrine layer that tells the investigator not just what to do, but why those steps in that order, grounded in how actors in that typology actually operate.

Universal Forms

25 universal forms are provided separately as a one-time subscriber download.

Delivery Framework

Case requests → secure email

Dispatch → within 24–36 hours

Maximum → 3 playbooks / rolling 7 days

Monthly reports → scheduled delivery

Quarterly report → scheduled delivery

On-Demand Reports → separate purchase