Insurance claims are a common type of matter where investigations are conducted in order to verify the legitimacy of the claim or the extent of the claim. Insurance investigations rely on the gathering of evidence as well as interviews and review of records to make a conclusion about the claim's veracity.
Complete Corporate Services have been engaged by many insurance companies over the years to investigate claims made by consumers and businesses. With our extensive knowledge and experience in fraud investigations and covert operations, we have been able to save insurance companies a lot of money due to us weeding out the false claims.
A private investigator may be hired by an insurance company to conduct an insurance investigation. In this case, the private investigator would be responsible for reviewing the policyholder's records, interviewing witnesses, and gathering other evidence to determine the validity of a claim. The private investigator would report their findings back to the insurance company, which would then use the information to determine whether the policyholder is entitled to receive benefits under the policy and, if so, to what extent. The goal of the insurance investigation is to ensure that the policyholder is treated fairly and that the insurance company only pays out on valid claims.
An insurance investigation is a process that an insurance company uses to determine the validity of a claim. The investigation may be conducted by the insurance company's own staff or by an external party, such as a private investigator.
In this example, the insurance company has received a claim from a policyholder for damages to their home as a result of a fire. The company has reason to believe that the claim may be fraudulent, so it decides to conduct an investigation.
During the investigation, the insurance company or private investigator will review the policyholder's records, including the insurance policy and the claim form. They may also interview the policyholder and witnesses, visit the policyholder's home to assess the damages, and gather any additional evidence that may support or contradict the policyholder's claim.
Once the investigation is complete, the insurance company will review the findings and use the information gathered to determine whether the policyholder is entitled to receive benefits under the policy and, if so, to what extent. The goal of the investigation is to ensure that the policyholder is treated fairly and that the insurance company only pays out on valid claims.
The management at Complete Corporate Services have decades of experience investigating insurance claims for the following:
One of the key issues that is raised time and time again with these types of situations is whether or not an injury is a genuine complaint and whether the complaint reflects the true state of things. Additionally, individuals who have been injured report issues of facing apprehension from the other party in receiving fair benefits (such as WorkCover), in gathering evidence to prove negligence, and even in identifying the other person involved (such as in a motor vehicle incident where the other party ‘runs').
Workplace injuries, WorkCover matters and industrial disputes commonly give rise to issues of credibility and imbalance in power between the parties.
CCS has also helped many individuals successfully pursue their employer to correctly support their injury or WorkCover claim, identify negligence and initiate proceedings to recover compensation. We are experienced in locating witnesses and taking statements, which are vital supporting evidence for any injury claim. CCS has successfully conducted covert operations and uncovered evidence to support workers' claims that an employer was negligent, which has resulted in fair legal proceedings and the award of compensation for the victim.
We have been engaged by employers facing claims of injury from workers, who want such claims investigated. In one case study CCS conducted covert operations and found that a worker, who was pursuing a common law claim against the employer, was caught working another job which involved physical labour and was contradictor to the workers' claim that he could no longer work due to injuring his back at the employer's establishment. The covert operation produced surveillance footage showing the worker carrying large loads; this was presented to him and the common law case against the employer was discontinued.
We are also frequently engaged by legal professionals to locate important witnesses and serve documents for court proceedings involving injury matters. Locating witnesses can literally make the difference to an insurance case.
Talk to us about the specifics of your situation. Over the years we have undertaken many investigations into insurance matters with outstanding success. We are familiar with Court process and legal procedures and disputes, and have a history of working with law firms to perform investigations that assist in achieving the client's desired outcome.
Whatever your matter, CCS understands that each matter is unique and provides a tailored service to match the client's needs. We place an emphasis on building long-term relationships with clients and have proven success in delivering desirable outcomes that meet and exceed client objectives and expectations.
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Complete Corporate Services (CCS) is an Australian-based company which specialises in a range of business support services.
CCS is directed and managed by Scott Sattler, who has over a decade of Risk Management, Investigation, and other business related experience. With over three (3) decades of other experience, our management team has more years of experience than any other known competitor.