AOE/COE INVESTIGATIONS

When it comes to evaluating a worker’s compensation claim, the main thrust for a claim examiner is to have quality information in a timely manner, so they can make an informed decision.

Our compensability investigations focus on just that. Our investigators are trained and skilled in the art of interviewing, scene investigation, and accident causation, followed-up by thorough documentation.

We use state of the art recording equipment, digital cameras, advanced computer systems, and quality customer service to accomplish this. We are truly your eyes and ears in the field.

When a worker is injured, primary focus is placed on their health and welfare. An in depth investigation of a serious accident can reveal many things, which may be valuable to the claim examiner and the employer.

Our investigators are trained to seek out causation issues and identify if there is a third party recovery potential. If a third party opportunity is discovered, we immediately communicate this to the claim examiner.

We secure that opportunity with proper source identification, securing of recorded statements, photographs, video-taping, insurance determination, and evidence collection if applicable.

From time to time, a claim examiner is assigned a worker’s compensation claim where fraud is suspected. These claims can be extremely challenging, because of the dual responsibility of the examiner, civil and criminal.

Our firm specializes in the investigation of suspected fraudulent claim activity. We have investigative experts who have made a career of investigating insurance fraud, and know the law thoroughly when it comes to handling these situations.

We work closely with the claim examiner, the Department of Insurance Fraud Bureau, and the local District Attorney’s offices in the investigation of these matters.

There are times when an injured worker’s activities are in question. When this occurs, the need for quality surveillance experts becomes necessary.

We have focused intently on providing quality sub-rosa services to our clients. With highly trained, thoroughly experienced investigators, utilizing state of the art surveillance equipment, we produce results.

In addition to skill, our intuitive investigators keep an open line of communication with the claim examiner to insure we are most effectively using our clients time and resources.

Our philosophy is to provide the information to the client as soon as possible so an informed decision can be made.

One of the most challenging management issues in a worker’s compensation case is Return to Work. Historically, surveillance has been used to try and determine if an individual is malingering and truly able to return to work.

We have developed an innovative, cost effective method of investigating return to work issues in a straight forward manner, instead of taking the initial covert route.

By paying a visit to the non-represented injured worker, conducting a limitations and treatment interview, and surveying their environment, one can gather valuable information, which can motivate the individual and medical providers to re-evaluate RTW readiness.

When evaluating a worker’s compensation claim, there are times when a claim examiner needs more information about a claimant, witness, or other involved party.

It is at this time that quality background and database investigations become necessary. We have access to one of the most up to date database services available in today’s market.

Our expert computer investigative specialists can obtain information on civil filings, driving history, property ownership, bankruptcies, judgments, WCAB filings, neighborhood demographics, and almost any public record, that is automated.