Insurance Claim Investigations/Insurance Claim Surveillance
Empathy Claims is an independent claims adjusting company that has worked in the field for insurance carriers and self-insured entities for many years. We have an excellent reputation for our outstanding work and dedicated team of experienced professionals. In addition to our quality claims adjusting services, we also provide special investigations and surveillance services for insurance companies. It is an unfortunate thing that while a great majority of insurance customers are honest, ethical people, there exists a small percentage of claimants who are out to defraud the industry. The Empathy Claims special investigations and surveillance teams specialize in helping insurance companies with claims fraud investigation, and the process of stopping it, wherever it may be attempted. You can trust the professionals at Empathy Claims to be your advocates in the field for any of your surveillance claims.
Insurance Fraud Investigation
Empathy Claims provides insurance companies all over the United States, Canada, Mexico, U.K., Ireland, and many more regions insurance fraud investigation in the following areas:
In an effort to help protect you against insurance fraud, here are some of the claims fraud investigation services available through Empathy Claims:
Personal injury and workers’ compensation fraud have unfortunately been around for a long time. In the attempt to validate whether a claimant’s stated physical condition is true and verifiable, a claims investigator will monitor a subject’s daily activities, movements and interactions with other people. These efforts have been proven to be a very valuable defense against insurance fraud. Workers’ compensation surveillance has also been a powerful tool in detecting fraudulent activity. The team at Empathy Claims are properly licensed, insured and have a full working knowledge of the laws pertaining to surveillance techniques. We also utilize the latest technology in our surveillance activities.
Activity check is an area where our claims investigators can monitor and make a record of the activities of a person who is attempting to make a claim for an injury or other kind of loss. The purpose of the activity check is to see whether the statements of loss to the insurance company are consistent with the activities in which the claimants are engaged.
Medical Records Canvass
The medical records canvass process is a time and labor saving activity that can provide insurance companies with a consolidated record of a claimant’s full medical history. Because not all medical records are accessible from commonly available hospital or insurance databases, the medical records canvass can pull critically important information on claimants from alternate sources. Such information could reveal the existence of a pre-existing condition or an addiction to pain medication. With the appropriate releases or subpoenas, our professionals can gain access to the full medical records of any person.
Civil/Criminal Background Checks
When a claimant is being investigated for fraud, gaining an understanding of their past history can be very enlightening. The purpose of a background check is to uncover any criminal convictions, civil court records, residence history or any other adverse information that could play a part in determining the character of the claimant being investigated for fraud.
Social Media/Internet Check
When investigating a case for insurance fraud, a lot of helpful information can be learned about someone on today’s social media outlets, such as Facebook. A person who is making a claim for a bad back injury could post a picture of themselves waterskiing on a lake or running a 5k race. This kind of information can play a critical role in proving that someone is trying to commit fraud on an insurance company.
Gaining a true and accurate understanding of a claimant’s financial condition can be very beneficial when determining whether insurance fraud is taking place. If a person is financially desperate or bankrupt, this could be a motivating factor in trying to commit fraud with an insurance company. Also, any statements to an insurance carrier about the financial position of a claimant can be verified as well.
Having a claims investigator verify a claimant’s employment status and work history can help a claims fraud investigator further understand the background of a claimant who might be trying to conduct illegal activity.
This service involves the locating of a person’s residence or whereabouts. Sometimes a person who is trying to commit fraud will vanish by moving to another state or city. The skip tracer’s ability to locate a person can be very beneficial during a claims investigation.
The dedicated professionals at Empathy Claims are committed to helping your insurance company detect, investigate and stop fraud at all levels. It’s fortunate that most people who file claims with an insurance carrier have a legitimate loss and are looking to be made whole from their insurance contract. But for those who are trying to defraud an insurance company, Empathy Claims wants to do everything possible through our professional network of investigators to see that dishonest people are stopped in their tracks. Insurance companies have counted on Empathy Claims for years to provide them with a quality service. Contact us today to learn more about how we can quickly dispatch a team to help you stop insurance fraud through our special investigations and surveillance specialists.