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Significant Bodily Injury Claim Denial Recommended After Investigation Discovers No Insured Liability

Overview Of Claim
An insured contractor covered under a commercial liability policy provides snow and ice removal services during the winter months to a retail store operation. Accessing the premises of a retail store, a member of the public slipped and fell in an area the contractor had cleared of any natural or unnatural accumulation of snow and ice.

The claimant suffered significant injury and stated that the cause of the accident was due to snow and ice not being properly removed from the entrance of the store. Being put on notice of a claim, the insurance carrier retained the services of Empathy Claims to investigate the incident.

Independent Commercial Liability Adjusters
On behalf of the insurance company, Empathy Claims began a full investigation of the slip and fall accident to determine if any liability existed on the part of the insured snow and ice removal business. 

We obtained a statement from the insured and it was confirmed that he performed snow and ice removal services as stipulated in the contract.

In addition, during the scene investigation, Empathy Claims obtained and reviewed video surveillance images of not only the slip and fall accident, but also general foot traffic going in and out of the store during the same time period.

Claim Investigation Results 
As the result of a comprehensive review by Empathy Claims regarding the circumstances surrounding this incident, it was determined that no evidence of liability existed on the part of the insured contractor, nor was any negligence proven related to the claimant’s fall. Security video clearly showed that the entrance to the store was free of any snow and ice hazards.

In addition, the video captured multiple people entering and exiting the store with no difficulty. The claimant had a clear view of any potential hazards and walked into the premises without any problems. It was also learned that the claimant had a history of prior knee injuries. In light of our investigation, we recommended that the insurance carrier issue a denial of the claim.

Experienced Liability Claims Adjusters
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For over three decades, the dedicated team at Empathy Claims has been providing the best independent adjusting services that the industry has to offer. We are committed to an unmatched level of claim adjusting excellence and customer service.

This case study shows that as a result of our investigative abilities, industry knowledge and attention to detail, we were able to determine that no liability existed on the part of the insurance carrier with regard to this accident. Contact us today to learn more about why so many insurance companies and self funded entities have chosen us to be their trusted partner.

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