Gain efficiency through claims investigation services

Importance of damage investigation

Underwriting and claims investigations are the two most compelling perspectives in an insurance company’s operation. In today’s commercial environment, where competitiveness and financial benefits are key business cornerstones, claims research can serve as a market differentiator that puts insurance agencies at the forefront of industry leadership and innovation.

To be effective, insurers must improve the operational productivity of their claims processing and build a working model that can minimize claims costs and also save the unnecessary costs associated with managing both genuine and fraudulent claims.

Numerous insurance providers have diverse claims operations, personnel and units that focus on the products and services (life and casualty) they offer to people or across different business sectors. This model often entails massive claims operations with distinctive unit designs, system infrastructure and procedures for each market or industry. In addition, claims for fraud, waste, and abuse are the ones most distressing insurance companies in large-scale or exceptionally complex operations. It is here that the claims investigation process works wonders and helps insurers become more efficient in their day-to-day operations.

Understand claims research

The Claims Investigations process is a process in which insurance companies, insurance examiners or investigators obtain data to assess a claim. So it may be necessary to examine documents, find witnesses, talk to individuals, assess property e.g. vehicles, accident sites to give some examples. Furthermore, these investigations can lead to taking pictures, videos, finding witnesses, talking to the victims, claims managers and much more. In addition, insurance companies are looking for competent partners who can provide all the services of the claims investigation process, and this leads to the need for an external administrator who can work with the insurance providers to settle the claims and provide valuable suggestions.

Different forms of a possible fraud claim

Fraud is a general term used to depict an act of deception by an individual or group. This act of cheating can come in different configurations. For example, insurance researchers try to discover the individuals who are making false claims with a specific end goal of getting insurance money. Similarly, intellectual fraud occurs when counterfeit items are passed off or sold as originals. Mortgage fraud occurs when someone has falsified paperwork to ensure a loan goes through. Since each of the claims mentioned above falls into the category of fraudulent claims, having a certified claims investigation agency can only make it more efficient in every step of the claims assessment process.

After all, you must be aware of the fact that fraud is a massive problem that costs insurance companies billions of dollars every year. In such a scenario, having a reliable insurance claims research partner can really leverage the workload of an insurance company’s in-house workforce. And with integrated platforms and digitized reports, you can present real-time information about every claim investigated.

See also  Assessment clause - dispute over insurance claims

By following these points, you can evaluate the quality parameters of the claims investigation service and check how well they fit your business.