How to Investigate an Insurance Claim

How to Investigate an Insurance Claim

How to Investigate an Insurance Claim, By conducting a due diligence background investigation and furthering that up with a surveillance on the subject, you can help investigate an insurance claim. This is only for people working in the field who have authorized access to the appropriate search mechanisms, such a detective.

Start by doing a quick criminal and civil search. You’ll be able to find out whether a person under investigation has any criminal or civil charges and any findings of guilt.

Look for divorce files. Divorce files are a wealth of information along with financial background information.
Insurance Claim

Note the use of such searches. These two actions are a good indication of a subject’s prior activities. For example, a subject’s ex-spouse may just make claims of physical abuse, fraud and or adultery.

If there is an issue of fraud in the claim file, this enhances the adjusters or defense counsel’s case. If there is a claim from the spouse, this is golden.

Copy the entire divorce file.

Copy the entire criminal file.

Conduct a proper and discrete surveillance to confirm the activities of the subject on video tape.
Provide the client with the surveillance video tape along with a report of the activities. Along with

Don’t provide opinions in the investigation report. Read More

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How to Investigate an Insurance Claim
Depending on the extent of injuries claimed from an accident as well as property damage i.e. the claim value, an insurance carrier will invest resources into investigating the claim. Interviews with witnesses to the accident, passengers in the vehicles involved are used to help determine fault. If a police report is filed, that is used as well to determine fault. Liability however is often only half the battle.

 

Investigating injuries is a different story. In order to receive compensation for injuries sustained in an accident, the burden of proof is on the injured party. Insurance carriers are notorious for reviewing medical reports and medical imaging to determine if someone is simply “faking it.”

 

This can make it difficult for parties with poorly documented prior conditions or patients with soft tissue injuries that are not readily apparent on an MRI.

Often times, specialists are requested by attorneys on both sides of the claim to give expert testimony to the nature of the injuries and the impacts on daily living the injuries will have in years to come.

In addition to reviewing all pertinent documentation regarding the injury, large insurance carriers often look at the injured victim’s social media profile(s) to determine whether or not their daily lives have been impacted.

It is for this reason that I tell my clients to refrain from posting (not to delete previous posts) while their case is active.

What makes this more difficult is the fact that most of time, people are tagged in photos other people post. If you were in an accident and injured, I would recommend that you consult with an experienced personal injury attorney to review the case and advise you accordingly. Best of luck. Source  Scott J Corwin, Motor Vehicle Accident Lawyer

 

 

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