Claim investigators' fact-finding missions are driven by careful attention to detail and practical experience, and the information that they uncover can play a valuable role in the overall claims resolution process.
To use claim investigative services in a meaningful and effective way, it's important for risk managers to have a sound understanding of what these services entail, when to deploy them, and how they can contribute to a valuable outcome.
Risk managers have several variables to consider when deciding whether to use outside investigative services. When the claim examiner is unable to obtain the necessary information or documentation to appropriately adjudicate a claim, for example, or when potential "red flags" or other suspicious indicators are identified by a claim examiner, it may be appropriate to seek the assistance of an investigator.
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