by Ed Snaneh, Chicago Auto Claim Specialist

In a simple language, it is the adjuster’s task to investigate and collect the facts concerning an auto accident/ home damage or loss. We can liken this to the journalistic or marketer take on a reporter’s tasks as delivering the four W’s (and one H): who, what, where, why, and how.

Adjusters could not create facts but they could unearth them. Fact-finding is a continuous process, but it is one best attained as close as possible to the time of the accident or loss. The reason is basically due to the fact that, with the passage of time, the investigative trail loses momentum and may go cold. Memories fade. Physical evidence deteriorates, degrades, or simply vanishes. Important witnesses move, never to be found again. For those and other reasons, investigation is a time-sensitive process with an often short shelf life. This is a main reason why insurance contracts require that policyholders report claims and losses as soon as possible. Time is critical.

With that in mind, the timing for receiving a notice of loss can vary widely. Sometimes, the adjuster may be called to an accident scene within hours or minutes of the loss. On the other hand, it is not unusual for adjusters to receive a notice of loss weeks, months or even years after the occurrence in question. On other occasions, the arrival and reporting of lawsuit documents may constitute the adjuster’s first notice of a loss. Lawsuit documents may be filed literally two or even more years after the date on which an accident takes place.

Investigative methods represent a major topic beyond the scope and intent of this article.Nevertheless, to provide an overview of investigative techniques and avenues utilized by claims adjusters, the following points are worth mentioning:Chicago auto insurance

  • Questioning Claimants: Statements taken by the adjuster from the claimant, policyholder, witnesses (these statements may be signed statements, notarized statements,  or even recorded statements).
  • Official Records:  Police accident reports of auto collisions, fire department cause and origin reports, coroner and intoxication reports (particularly in cases of massive bodily injuries and death claims), death certificates, etc.
  • Photographs of Accident Scenes: Photos and physical evidence, allegedly defective products or components, photographs of scars where disfigurement is alleged by a claimant people.
  • Gathering Available Physical Evidence
  • Medical Records. Obtaining medical information by procuring signed medical authorizations that allow claims handlers to obtain medical reports and records to investigate the nature and extent of claimed bodily injuries.
  • Sub Rosa (i.e., secret). This is the process of activity checks in the area of an injured party to examine and investigate the true nature and extent of professed injury or disability.

The above was not a complete tally. It is vital to understand that investigation is a process that claims handlers do in order to settle any issues that they may have over coverage, liability, or damages. Investigation can pertain to any one of these components or to any combination.
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