Claims Investigations

The Claims Investigations process is one in which Insurance Companies, Insurance Examiners, or Investigators obtain information to evaluate a claim. As a result it may require perusing documents, locating witnesses, visiting and interviewing people, inspecting property such as vehicles, accident sites and physical locations to name a few.

These investigations may lead to taking photographs, video, locating witnesses, interviewing victims, bystanders, employers and much more. Investigators are looking for evidence that a claim is legitimate or illegitimate. Keep in mind that other claims-related services listed in this section may also be required to get those answers.

Unfortunately Claims Investigations are needed because, although many claims are legitimate, there are some that are not. Statistically, these illegitimate claims conservatively cost $80 billion dollars annually across all lines of insurance. We work with Insurance Companies, Employers and Attorneys in a defense capacity. We handle a variety of claims. Some of these are listed below:

• Asbestos Claims
• Bodily Injury Claims
• Disability Claims Defense
• FMLA (Family Medical Leave Act)
• Insurance Claims
• Intellectual Property Claims
• Liability Claims
• Medical Malpractice Claims
• Mesothelioma Claims
• Motor Vehicle Accident Claims
• Product Liability Claims
• Slip and Fall Claims
• Workers’ Compensation Claims
• Other Claims as Needed

Listed here we offer some related services in support of Claims Investigations and a brief explanation of each.

Preliminary Record Searches are defined by the investigative industry as a check of public record sources as well as investigative and proprietary databases.  These searches can also be referred to in part as Background Investigations or Background Checks.  Corporate Investigative Services, Inc. is a well respected, time tested professional investigative agency that is well equipped to handle your Preliminary Record Searches.

If you are in need of Surveillance Services and you are a Workers’ Compensation Attorney, a Self-Insured Employer, a Claims Adjuster for a Third Party Administrator, an Insurance Adjuster in defense of a claim or have any other legitimate business need, look no further.

When an event occurs, for example, a theft investigation, a fraud investigation, a loss, a fall, an injury, a workers’ compensation investigation, or a motor vehicle accident investigation, it is imperative to know exactly what happened. How do we do it?  We do it through Interviewing and Statement Taking.  These can be our best information gathering tools.

An interview is a conversation consisting of questions and answers to document an event and gather information in order to determine the Who, What, When, Where and Why of the event.

Witness Locates are becoming more commonly requested especially if there has been an accident, incident or event.  You have to ask yourself, did somebody see something? The more complete questions are:

• Who are the witnesses?
• Where do they live?
• How do I contact them?
• What did they see?

Fraud is a general term used to describe an act of deceit by an individual or group.  This act of deceit can come in many different forms. For example, insurance Fraud Investigators try to expose those who make false claims in order to get insurance money.  Workers’ compensation fraud investigators seek to expose workers who try to claim compensation for non-existent injuries or for injuries that occurred outside of the workplace or during off hours.

The claims investigator’s job is to investigate the claim and present the findings so the customer can make a reasonable decision based on facts.