Loss Adjusters and Claims Investigators should always have a system in place when investigating Red Flag Claims. It is not sufficient to simply call by appointment and ask questions and call this an investigation.
It is important to have gained as much knowledge regarding all aspects of the claim as possible before any face to face discussion takes place. This is not to say that there should be any delay in dealing with the claim as speed in visiting the scene and collecting data and information is crucial in any investigation.
Local knowledge plays a big part in any investigation so research the area if it is unfamiliar ground. Don`t be afraid to talk to locals who often visit the scene of major events and are often in possession of important information that they are quite happy to share if asked.
Always be aware of the Data Protection Act when gathering information. Your job is to gather information and not to supply it to unauthorized persons.
The use of Conversation management and SE3R (Forensic solutions) is a tool that every claims investigator should have a solid understanding of.
Never attend a meeting or scene unprepared and always have your questions prepared before your visit. It is also vital to be able to see flaws with regard to explanations and be capable of responding with further relevant questions where necessary.
Always remember that the policy holder may be completely innocent of any wrong doing and just because a claim may initially look suspicious there may be a perfectly good reason for this. it is extremely important that policy holders are not made to feel they are being accused of anything.
The purpose of the exercise is simple to get explanations where certain aspects of the claim were initially classed as Red Flag issues.