Fraud is an ever-present
problem across all lines of insurance. Vigilance and the use
of skilled investigators are necessary to reduce payment of
fraudulent claims and deter others inclined to criminal gain.
With all the advances of technology and the Internet, successful
investigation most often results from old-fashioned virtues.
The first of these virtues is an experienced investigator
with a strong desire to understand the truth. With the right
investigator in place all becomes possible.
All our investigators are full time employees; we do not sub-contract
work in our service areas.
We specialize in the following services:
Surveillance:
We use the best equipment in the hands of experienced investigators
to produce videotape of claimants doing what they say they
cannot do. Claim denied. Our reports are prompt and to the
point. Our investigators are trained in the regulations and
rules regarding expectations of privacy and permissible activity.
Compensability (AOE/COE) Investigations:
Is it an injury arising out of employment? Did it occur in
the course of employment? Our investigators conduct the interviews
with witnesses, supervisors, fellow staff and the claimant
to determine whether the claim has merit. Increasingly claims
departments are using such investigations early in the life
of the claim to reduce fraud.
Background Checks:
The Ventura branch has access to a multitude of data sources
and investigators experienced at ferreting out the facts.
We can provide you with asset data, criminal and civil legal
records, and much more.
Special Investigations Unit
(SIU): David Morse & Associates is the
designated SIU for several national carriers, assisting in
identifying fraud indicators, establishing procedures for
dealing with suspected fraud and providing the continuing
education requirements. The Ventura branch has skilled
investigators to conduct investigations on your behalf, including
Statements Under Oath, preparing cases for referral for prosecution,
conducting medical clinic inspections and other investigations
specific to insurance fraud. |
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