Insurance Investigation

Insurance Industry Investigations

RRIS’s extensive client list is a tribute to the level of satisfaction that results from our engagements with the private insurance industry. Our team of investigators is well experienced in the detailed documentation of an individual’s daily activities which include casualty surveillance, background checks and activities checks. Our discreet surveillance techniques provide credible evidence that support repudiation of claims for income replacement, accident benefits, bodily injury or short and long term disabilities. We have helped thousands of adjusters and defense attorneys from coast to coast to gather the information they need to make educated, responsible claims decisions.

Insurance Investigation

Workers Compensation Activity Checks and Surveillance

If there are “red flags” which indicate that an injured worker may be exaggerating and/or malingering, an activity check may be warranted. An activity check provides valuable information of the subject’s current lifestyle. Its purpose is to provide a synopsis of the subject’s physical and mental state, as well as information regarding possible subsequent or current employment.

We can also conduct surveillance to further ascertain social, employment and recreational activities. The client will be provided with a full and detailed report relative to the findings of our investigation. Most cases can be completed within two to three weeks.

Red Flags

  • Disgruntled, soon-to-retire, or facing imminent firing or layoff.
  • Involved in seasonal work that is about to end.
  • Took unexplained or excessive time off prior to claimed injury.
  • Takes more time off than the claimed injury seems to warrant.
  • Is new on the job.
  • Is experiencing financial difficulties.
  • Changes physician when a release for work has been issued.
  • Has a history of reporting subjective injuries.
  • Rehab report describes the worker in a manner inconsistent with claimed incapacity, including: being muscular, well tanned, callused hands, and grease under the fingernails.
  • Accident occurs soon after return from weekend, holiday or vacation.
  • Accident is unwitnessed.
  • Claimant is injured at an odd time, e.g., lunch hour, before normal working hours.
  • Fellow workers report rumors that accident was not legitimate.
  • Accident occurs just prior to a strike or near the end of a probationary period.
  • Employer’s first report of claim contrasts with description of accident set forth in the medical history.
  • Details of accident are vague or contradictory.
  • Incident is not promptly reported to supervisor.
  • After injury, worker is never home or spouse/relative answering the phone states the worker “just stepped out”.

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