How To Handle An Insurance Investigation

Do you need to file a claim with your insurance company? Prepare to be investigated. Whenever you call your insurance company to submit a claim, they are going to aggressively investigate the claim. Each insurance companies differs in the methods they use to investigate claims. The details that they look for also differs. However, what they all have in common is what they’re looking for: evidence that your claim is actually legitimate.

Even if your insurance company decides that your claim has merit, they will continue to investigate anyway. The reason is because they need to ensure that the scope of your claim is not exaggerated. They want to make sure you are not overreaching in the amount of money you are seeking. Basically, they’re making sure there’s no fraud involved.

Insurance fraud is divided into two different types. These are hard fraud and soft round. Hard fraud is when a person makes a completely false claim in order to gain a profit. These types of claims are infrequent. As a matter of fact, studies have shown that hard fraud occurs less than 1% of the time.

The other type of fraud that your insurance company will look for is soft fraud. Soft fraud occurs when someone files a legitimate claim, but they exaggerate the value of their claim. Here’s an example. Someone is involved in a fender bender accident that hasn’t caused any physical harm. Instead of just filing a claim for the damages, the person may report it as an injury claim. This means they stand to gain more money from the insurance company. Soft fraud is far more prevalent than hard fraud, but it still doesn’t happen often. Between 3% and 10% of an insurance claim is soft fraud.

When the company asks you questions, does research on your history, and asks questions of your friends and neighbors, they are attempting to uncover any potential soft fraud. They will not stop investigating until they are sure that your claim is legitimate.

However, you don’t need to be worried (unless you’re actually committing fraud). These investigations are similar to the security checks you go through at the airport. They’re typically done just to see if there is anything suspicious about your claim.

This post will provide some tips that will make it easier for you to go through the investigation process.

Keep Calm

Don’t become angry, nervous, or aggressive with the insurance claim adjuster. They’re just doing their job. If you behave in a way that is aggressive, they will probably come to the conclusion that you have something to hide. This wouldn’t be good for you, or the adjuster. Just let it happen. It’ll all be over soon.

Build Credibility

Since the adjuster is looking for you should be as forthright as possible when you’re discussing the claim. For instance, if you had an injury prior to a car crash, tell them. Don’t wait for them to ask about it. If you are proactive about sharing this information, you will build more trust and credibility. If you don’t give them this information and it’s discovered later, it could have a negative impact on the rest of the investigation.

Don’t Exaggerate

It’s important to make sure you are accurately explaining the injuries you have received. Don’t make small injuries sound worse than they actually are. You don’t need to go over every single minor injury you had since the crash. If you have sustained major injuries, then you definitely want to talk about them. But you don’t need to describe every minor injury you experienced. This will help you further build credibility with the adjuster.

Know When To Call For Reinforcements

Ideally, the investigation process will go as smoothly as possible. You will have built enough credibility to satisfy the adjuster. However, in some cases, the investigation might become excessive. If you feel like the investigator is asking too many questions or prolonging the investigation, you may want to consider speaking with an attorney who can help you.