RESULTS!!! Seven Tips for Insurance Adjusters and Investigators

4
June 2015
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In recent years, we have experienced a number of potential clients complaining about past surveillance results.  Many people in the claims industry have experienced frustration due to the lack of video investigators have secured.  In today’s world with the internet, video games, smart phones, social media, high gas prices and inflation, peoples every day outside activities have been diminishing.  With that being said, experienced investigators can take advantage of the little things that can lead them to big results. Investigators are not going to obtain numerous amounts of video on a daily bases.  There are a lot of things that are involved when being out in the field that are completely out of the investigators control such as traffic, noisy neighbors and weather.   Any investigator that claims he or she has never lost a claimant is lying.  I will be the first person to tell you that there is a lot of luck involved in this job.  With that being said, there are a lot of things that investigators and adjusters can do to increase their chances of finding success during the course of an investigation.

Here are seven tips that can help Investigators and adjusters with their investigations.
  1. Surveillance is a great tool for adjusters.  If a case cannot be settled and surveillance is needed, make sure you start off by choosing an investigation company that has a proven track record.  Using investigators with a lack of experience can and will frustrate you and cost you money.  Once you have done your homework and selected a company, your next step is to determine your budget.
  2. If you do pick up the phone and call an investigator to conduct surveillance on an injury claim, the first step is to trust what the investigator has to say.  Perez Investigation Inc.  always recommends starting off with two full days of surveillance starting at 6:30 a.m.  Often times it can take a half to a full day to get a case assessed.  Based on the results after two days, further time may be warranted.
  3. Try to avoid doing a 4 hour activity check.  More often than not, Claimants who are currently off work sleep in and take advantage of being paid without having to work.  If the investigator starts at 6:30 a.m. and leaves by 10:30 a.m., you are only covering a small part of the day where an individual can be active.  In the summer months when the days are longer, investigators have a large window in which they can obtain video.  Investigators chances for success depend on how long he or she is out in the field.  If you are on a tight budget and cannot afford to assign at least two full days of surveillance, then consider at least one full day.  Four hour activity checks are good only if you’re trying to establish whether someone has returned to work.
  4. Make sure to conduct a Social Security trace, ANI trace and social media check before starting an investigation.  If you are able to gather information from Facebook, Instagram, LinkedIn or other sites, your investigation can often times revolve around that.  Often times, people post information about upcoming events or activities that they will be taking part in.  This kind of information is gold for investigators working in the field.
  5. Always conduct surveillance on days when the claimant has a medical appointment. Often times a claimant will exaggerate an injury on the day of a medical or legal appointment.  The best way to gage where the claimant is at with their injury and if he or she is being truthful is to conduct surveillance the day before, the day of and the day after a medical or legal appointment.  This will paint you a good picture of how ligament the claim may be.  On multiple occasions, I have witnessed claimants moving around without showing any signs of discomfort the day before and the day after a medical appointment.  On the day of the medical appointment they are exhibiting visible restrictions.
  6. Different locations call for different measures; Often time’s claimants live in remote settings.  Conducting surveillance in a rural setting can be very difficult.  For experienced investigative firms, surveillance in rural setting is difficult but doable.  To start off, you are going to need two investigators assigned to a case in a rural area.  Having two investigators will increase your chances for success greatly however it is more costly.  The saying “you get what you pay for” could not be truer when directly linking it to surveillance.
  7. Communication is key.  It is very important for the adjuster and investigator to communicate before, during and after the case is completed.  The more information the adjuster is able to provide the investigator the better.  Some of the top investigation companies have case management systems which ultimately makes communication easier and more efficient.  With a case management system, the adjuster is able to send pictures, notes, comments and other information to the investigator on a timelier basis.