Investigations save claim costs paid by your company by determining the difference between fraudulent and non-fraudulent claims, or claims caused by an indirect or third party. Depending on the line of business insurance, these costs are made up of allocated and unallocated expenses, indemnity and medical payments. Claim dollars paid also affect your insurance premiums or bonds for qualified self-insured liabilities. It can also be a factor in determining the award of a contract “bid” amongst other things.
Your company benefits when an investigation freezes and preserves all the facts and parties to the occurrence, incident or accident at that time, as well as rooting out truths versus circumstantial hearsay. The more time that passes, the more likely chance that evidence is inadvertently destroyed, is no longer available and/or the details become less memorable by witnesses or parties involved. Medical information needs to be reviewed and corroborated in personal injury / workers compensation claims to substantiate details, facts and related injuries, ruling out unrelated prior history. Insurance policies, Contracts and Sub Contracts deserve careful review for “conditions”, coverage and exclusions. Third Party, or Subrogation investigations should be done simultaneously to identify opportunities for mitigating future monetary exposure potentially payable by your company.
While timely investigations are recommended, often the need for an investigation is not immediately evident until some later time. However, without an investigation, most questionable claims made, translate into more claim costs being incurred and paid out. Ultimately claim costs impact all companies margin of profitability. ARMIIS specializes in multi-line investigations, providing our clients with all the necessary facts, specificity & information with which to make informed decisions. Get increased control of your claim costs. Pay only the claim costs you owe, and not for costs you don’t owe. Use our investigative results for developing defense strategies with legal counsel or your Risk Management / Claim Team regarding claim “acceptance”, “denial in part or whole”, “defending” or “mitigating exposure” on litigated claims (in accordance with applicable Federal & State laws and regulations).
If there are any questions regarding the type of investigation needed, contact us and we will review it with you further, ensuring that all your concerns are clarified and resolved.