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Why Most Adjusters Feel All Insurance Claims Investigators Are The Same

Posts Tagged ‘ investigator ’

Why Most Adjusters Feel All Insurance Claims Investigators Are The Same

Friday, February 12th, 2016

The reason why most adjusters feel all insurance claims investigators are the same is because, well, they are.

Although within the PI world this is not a politically correct thing to say, the truth (albeit painful) must be told. Please understand that this is a generalization, but it holds true for most private investigative agencies. The average PI agency serving the insurance claims community is a very small business. They usually only have a handful of investigators, the majority of whom do nothing but local surveillance. They do whatever you ask. If you give them three days of authority, they do three days. They underpay their employees and often, particularly if they get busy, will subcontract someone else to do the work. They have limited resources, no intelligent processes to planning or risk management and you hope that the investigator never has to testify. In short, if you are an average adjuster, you are more likely to work with one of these types of agencies than with one who is consistently better. They almost always underwhelm, thus, the reason why most adjusters feel all insurance claims investigators are the same.

If you work in claims and are sick and tired of “the same” underwhelming work product from PIs, call Sherlock Investigations today.

Michigan to Turn Up Focus on Auto Insurance Fraud

Friday, December 26th, 2014

LANSING (AP) – A veteran investigator has joined the Michigan Secretary of State’s Office to crack down on auto insurance fraud and other scams.

Secretary of State Ruth Johnson hired Al Kimichik as the department’s senior investigative executive. He began work Dec. 8 and most recently was inspector general for the state Department of Human Services, where he focused on fraud in public assistance programs.

He’s also been an investigator in the Environmental Quality and Natural Resources departments.

Johnson said Tuesday that Kimichik is an “accomplished fraud-buster” who will oversee and implement her plan to target fraud. She wants to expand verification of insurance certificates the department receives from drivers, upgrade software and do data analysis to identify signs of potential fraud.

Kimichik has 25 years plus of investigative and law enforcement experience.

(Copyright ©2014 by The Associated Press. All Rights Reserved.)

Disinformation posted by some plaintiff firms about casualty claims surveillance

Thursday, November 13th, 2014

In a recent Google search about casualty claims surveillance tactics, one of our team noted that most of the information that comes up on the first five pages was posted by plaintiff lawyers. Many of them nationwide seem to love the idea of warning their prospective clients about the possibility of surveillance being conducted on them and list a number of things to do to prevent or thwart the investigators. Given that surveillance is one of the only ways to determine how disabled or limited one may be, it makes sense that plaintiff attorneys would rather see this technique fail to disclose the truth as often as possible. What we also noted is more disturbing. A large number of these articles or blog entries go beyond discussing surveillance and actually try and convince the reader that insurance companies actively try to deny legitimate claims, through the use of surveillance, and  indicate that carriers will break the law to do so.

Here are a few quotes that serve as good examples: “Remember, the insurance company’s goal is to not pay you what it owes you”, “insurance companies sometimes engage in unfair surveillance tactics” and “hired gun investigators will often manipulate surveillance footage”. We stormily resent the idea that the insurance industry aims to deny paying a legitimate claims. The insurance industry is highly regulated by state government and audited. There are also numerous ways for claimants to report unfair insurance practices if they occur. Lastly, we have been working for a wide variety of carriers and defense attorneys over many years and have never witnessed any attempts to deny a claim without a strong reason to do so. What is certainly far more true is the massive number of casualty claims that are fraudulent or grossly embellished by unscrupulously claimants and their money hungry counsel.

Detroit Auto Thefts High But On The Decline

Tuesday, August 19th, 2014

Good news, bad news. The NICB recently released it’s list of the most stolen vehicles in 2013, by make and model. A quick glance at the list tells the story; foreign economy sedans and domestic made pick up trucks dominate the list. The Honda Accord came in in first place but, speaking of Detroit, all three of the US car manufacturers had full size pickup trucks in the top ten.

Interestingly, the auto theft statistics from Detroit in 2013 reported the Detroit auto thefts declined by 7+% to 12,341. Still not a great number, but at least the number is going in the right direction. The top models reported stolen in Detroit by NICB are the Chevy Impala, Dodge Caravan and Ford Fusion. Obviously with this many Detroit auto thefts, the work load for insurance investigators in the area has not fallen off and insurance rates are insanely high as a result.

If you are a carrier looking for help with field work like neighborhood canvassing on Detroit auto thefts, Sherlock Investigations is here to help. Detroit insurance investigators.

Surveillance on IME Day

Thursday, August 14th, 2014

For those of you who prefer to schedule surveillance in conjunction with an IME, here are some quick tips to help improve the outcome.

Let us know if transportation is being provided. It makes it easier on the investigator when establishing our initial surveillance position but more importantly, some of the transportation companies will be looking for surveillance and may even tell the claimant they are being followed. We know who some of those bad apples are and can plan accordingly.

Try to schedule the IME between heavy traffic / rush hour times. With any of the major IME clinics located in congested areas like Southfield Michigan and Novi Michigan, rush hours can cause headaches and potentially cause a good investigator to lose a claimant in heavy surging traffic.

Lastly, request that the IME provider not move the schedule. Most medical practices try and compact the doctor’s schedule as much as possible and often times they will move the appointment time, but not tell you. We want the doc to be able to get to the golf course as soon as possible, but it might be better if this appointment stays put for the surveillance investigator.

With Harsh Winter Over, Insurance Claims Surveillance in Michigan Helps Insurers

Thursday, May 8th, 2014

After the harsh winter of 2014, everyone in Michigan is happy to be get outside and get back to living a normal life. This includes those who have file a an auto no-fault (pip) claim alleging they sustained injuries in an auto accident. Within that group, some are filing claims alleging they have injuries when the do not. Others within that group are embellishing their claim to “make some money”. Since insurance carriers have very limited ways to tel if someone is actually injured or not, and since Michigan has so much insurance fraud ongoing, many use insurance claims surveillance, conducted my Michigan private investigators, to try and detect fraud and misrepresentations. Sherlock Investigations is a leader in insurance claims surveillance in Michigan. Insurance claims surveillance is one of the the best way to determine if someone is actually injured or not. It is done in public and it does not involve invading anyone’s privacy.

Michigan PIP Claims Surveillance On The Rise This Summer

Wednesday, June 26th, 2013

With the improvement in Michigan’s weather and TV commercials for legal representation in first party auto claims at an all time high, smart carriers are increasing their use of Michigan PIP claims surveillance statewide with private investigators. In many instances, when a casualty PIP claim appears to be fraudulent or embellished in some way, carriers are taking advantage of the good weather to document exactly what claimants are actually capable of doing on an average day. When one claims not to be able to return to work or requires replacement services, it is expected that they would not be seen washing their car, going to the fair, planting flowers, playing catch with the kids or any of the other things that normally occur in our lives each summer.  With Michigan PIP Claims surveillance is conducted on the injured policy holder who files a claim for benefits after sustaining injuries in an auto accident. In May and June, Sherlock Investigations has seen a combined 18% increase in requests for Michigan PIP claims surveillance over last year and this increase is coming from a wide variety of carriers.

In the past five years, Michigan PIP claims, or first party claims, have grown substantially and the number of law suits in this space has grown almost exponentially as more attorneys have found this to be a lucrative area to make money in. PIP is also the fastest growing area for insurance fraud in Michigan. Smart carriers are fighting back be increasing their use of Michigan PIP claims surveillance with Sherlock Investigations (Michigan Private Investigators specializing in claims surveillance) on speculative PIP claims.