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Insurance Defense
Texas insurance fraud private investigator knows that it has been estimated that insurance fraud is a $150 billion dollar per year expense. Most companies have under staffed SIUs, or do not realize how to deter, detect or investigate allegations of insurance fraud as they rely on a provider to handle this burden. Even then, most companies are only saving $1.00 per every $95.00 lost to fraud. Too often, surveillance is often the only investigation that is done on a claim to determine its' validity. Our experience shows that by combating allegations of fraud at the onset of the claims process is an effective deterrent in fraud control. By utilizing witness interviews, scene investigations, vehicle inspections, surveillance and other investigative options you will be able to validate or deny claims made against the policy.
Trinity Investigations' philosophy is to provide our clients with exceptional investigative services. Our experience in SIU investigations and management will help us to work with you to develop investigative strategies for your particular situation. By providing our clients with an exceptional work product designed to meet their specific needs, we can help you to make informed decisions in your claims handling process.
Services provided:
-Examinations Under Oath - Vehicle Photography - Clinic Verification - Dedicated SIU Services - File Review and Audit - Database Research - Medical Billing Verification - Surveillance - Mandated Fraud Reporting - Civil and Criminal Research - Activity Checks - Witness Locate - Scene Photography - Subrogation - Statements - Low Impact Claims - SIU Best Practices - State Mandated Fraud Plans - Auto Thefts and Fires- Alive and Well Checks - Catastrophe Fraud
Catastrophe Fraud: When a catastrophe strikes, insurance personnel are often overloaded with claims and the pressure to settle these claims quickly. Criminals recognize and exploit these crises. We will verify receipts, provide on scene investigation to confirm the presence and condition of claimed items, confirm damage to property and surrounding area, verify receipts and obtain statements from the insured and all parties involved in the claim. We can also tailor our investigation for your specific need.
Surveillance: By observing and documenting through the use of video tape evidence, is the most effective tool used by the insurance industry, law firms and their business clients. Video tape documentation is an important factor in evaluating the truth.
Clinic Verifications: In-person visit to clinic location to verify existence. May also include an interior inspection to confirm the presence of medical equipment. We also verify medical licensing and check for disciplinary actions. We can also provide continuous surveillance of the location from the time the business opens to the time that it closes. We describe all activity during the day and document all visitors vehicle information and descriptions of people entering the business. Medical Billing Verification: We will compare billing with the providers records. We can also obtain statements to verify from the patient the extent of their billed treatment.
Accident Investigation: Tailored to meet your claim need. These can include scene photos and diagrams, vehicle inspections, measurements, canvas for witnesses and statement taking of witnesses and all involved parties.
Alive and Well Checks: The investigator will visit the claimant's address to confirm that they are still residing there. Investigator will provide a description of the claimant and their residence. if requested, we can verify their injury and if they are still receiving their checks. If the claimant is overly active, we will attempt to document these activities with video. We can also drop off checks, obtain additional statements or provide forms to the claimant.
Low Impact Claims: Tailored to meet your claim need. These usually include documenting the damage to both vehicles with photographs and measurements. (we include interior and under carriage photos as well) Scene investigation, interviews with all parties either by phone or in-person which is usually best, contact investigating officer for their observations at the scene and document retrieval.
Statements: Either in-person or by phone. We will cover all aspects of the claim and focus on important and relevant issues relating to the claim. Examinations Under Oath: We have experience in conducting over 600 EUO's. We will tailor our EUO to address the specific issues in your claim process according to your policy specifications.
Auto Thefts and Fires: We provide inspection of the vehicle to determine the probable origin of the fire. Obtain photos of the vehicle, check fluid levels and obtain samples as directed, Check column and ignition for damage, check other areas of operation and check interior for physical evidence. We attempt to verify the vehicles true identity to ensure that you do not have a cloned, gray market or vehicle with a switched vehicle identification number Obtain photographs of the scene, statements from all involved parties, obtain documents and interview police and firemen.
Witness Locates: We use a variety of database searches to help you locate witness, or other parties involved in the claim. When we are unable to use these, we provide field investigation to help locate them.
SIU Services: We will tailor our investigation according to your specific claim needs. For companies with no SIU or with limited SIU, we provide training, SIU Best Practices development, State Mandated Fraud Plan development, assist in claims investigations and development of claims forms and policy language. Mandated Fraud Reporting: After investigation, we will refer suspect files to the appropriate agency as required by statute.
File Review and Audit: We will review your file for indicators of fraud and provide you with an investigation plan.
