Documentation of Insurance Field Investigations

Insurance field investigations and documentation of these via audio transcription of interviews or in other ways are crucial for insurance companies as they are part of their risk management process and help prevent fraudulent or invalid claim payments. It is a very challenging job since fraudulent reporting of claims is rampant and show up in many forms. Documentation of insurance field investigations requires a lot of effort that extends to several pages whether in the case of auto insurance, business insurance, home insurance, life insurance or health insurance. The most factual and detailed reports should be created if insurance frauds are to be clearly identified.

Investigation Approach

Even though the specific nature of the investigation may depend upon the exact nature of the claim, investigators usually follow a systematic approach to avoid losses. This approach includes:

>> Incident Overview – This involves compiling a short summary of the incident. The summary includes the claimant data, type, date, time, location and a brief description of the claim.

>> Interview with the Claimant – It is required to conduct an interview with the claimant or take the claimant’s statement either verbally or in writing to collect more details regarding the claim. A series of ‘who’, ‘what’, ‘where’, and ‘why’ need to be asked. More queries can be made if you need any additional details.

>> Documentary Evidence – You need to collect the documentary evidence related to the claim which may include police report, receipts, inventory records, invoices, shipping records, titles, bills of sales, diagrams, appraisals, proof of ownership, photographs or video records. The evidence collected should be scrutinized thoroughly to justify the claim or to identify any alterations or falsifications that could indicate a problem.

>> Physical Evidence – This includes fingerprints, damaged property, DNA or computer hard drives. You are not only required to scrutinize physical evidence, but also remain very careful not to tamper with any physical evidence.

>> Witness Statements – It is very important to take the statements of people who witnessed details or incidents related to the claim. Witness reports are crucial since they can be used for fact checking against the statements and evidence collected earlier. If discrepancies are found, additional investigative probing and further substantiation will be required.

>> Case Report – This report reveals the most compelling facts of the case. Instead of offering your opinions, you need to present only the facts and findings. Case report is very important when there are disputed facts and questionable evidence.

With this, it is quite evident that an insurance investigator is required to document a lot of details, statements and reports during field investigations. Gathering all the information and compiling it in a standardized manner require persistent effort. This information is to be presented before the insurance company so that the organization can take a final decision regarding the claim.

Importance of Insurance Transcription

It is best to record the statements and interviews related to field investigations and transcribe them later instead of taking down notes in between. Once you make sure that every piece of evidence is recorded properly, it would be practical to obtain transcription services to help you legitimize and quantify the investigation data. This will reduce your workload and streamline your investigation process in the following manner:

>> Simplify Routine Work – With a transcription service provider, you can avoid the extra work of fumbling with pens, papers, and forms during lengthy investigations. You can use a handheld device to record all your observations and the transcriptionists would summarize your findings or use the information collected to fill out the customized forms.

>> Focus on Interviews Better – Interviews with claimants are conducted for eliciting more detailed information and transcription is really helpful in these circumstances. This is because you can transcribe the audio verbatim which will provide key evidence that can be reviewed by adjusters and examiners. It is possible to customize interview transcription by including timestamps that will help the listener hear a specific portion in the conversation again. The timestamps help to simplify the job of examining crucial statements.

>> Flexibility for Surveillance – With a transcription service provider offering service, you can take up the task of surveillance at any time with much relief. Surveillance takes place at any hour of the day and night and it would be lengthy as claimants may exaggerate their injuries and you will need to gather all necessary data to find out their claims are true. Creating an audio recording of your notes and getting them transcribed later can save you considerable time and effort.

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