Insurance firms routinely undertake claims investigations to determine the legitimacy of a claim. The investigation process can help the claims adjuster make an informed decision on how to handle a claim. Insurance claims investigations are used to combat false or overstated claims. An invalid claim is irrational or incorrect, and you can avoid paying a fraudster potentially enormous sums of money if you identify it early. Insurance claims investigations use evidence, interviews, and records to establish whether or not a claim is legitimate. Let’s know how does a private investigator services NYC conduct an insurance claim investigation?
Claims Investigation Procedures –
The investigation of claims follows a similar pattern to that of previous inquiries. Gathering and analyzing documents, taking statements, chasing down and questioning witnesses, examining and photographing damaged property or accident scenes, undertaking surveillance, and analyzing social media profiles are all part of the process.
Gathering and Examining Documents –
As part of your insurance claim investigation, you should request and gather official records relating to the injury or damage. Request medical release paperwork, prescription records, doctor’s notes, or any other documents that can attest to the legitimacy and severity of the injury. You can get formal documents established by the hospital or the victim’s physician for a personal injury claim. Request the same things for workers’ compensation claims, as well as the OSHA form describing the incident. For a property damage claim originating from a car collision, obtain a copy of the police and accident reports. These reports will include information from the day the accident was reported, and they can be used to corroborate statements and details acquired during interviews.
Conducting Interviews and Taking Statements –
One of the most profitable methods to obtain information during an insurance claims investigation is to interview the victim, witnesses, and, if applicable, the culprit. Depending on the claim, you’ll ask different questions. Inquire about the items taken, when they first noticed something was wrong, and the identities of anybody there at the time of the theft when filing a theft claim. Read the claimant the original police report and see how they react.
Analyzing the Situation and Potential Suspects –
Take pictures or videos that can help you comprehend the story better. Depending on the claim, take photos of the area (workplace, residence, car, and intersection) as well as the injury. If you have access to a permanent, concrete perspective of the surroundings, you’ll be able to make sense of the claims and official records. It’s also a good idea to keep an eye on things. Keep an eye on how an employee spends their time after sliding and damaging their back on the hardware store’s wintry steps. Have you seen them walk into the studio? Did they go out and purchase a dining table, which they then loaded into their truck?
Getting More Contextual Information –
Finally, consider any extra contextual information that may help you better grasp the claim. Examine the claimant’s social media profiles to learn more about them and their situation. Recent posts about financial hardships or dissatisfaction with one’s job may trigger suspicions. Sports-related posts have the potential to cast doubt on an injury claim. Look to check whether they’ve made any previous allegations. Have they told the same story before? Is it true that the claim was fraudulent in the last insurance claim investigation? This type of discovery could have an impact on the investigation’s outcome.
Private investigator services NYC is the best bet if one is needed help in insurance claim investigation.