Handling Questionable Insurance Claims
Many things can go wrong in life, which is why people have insurance policies. They are necessary when you have suffered a loss in terms of property and limb. Before payment is made, it has to be clear who was responsible and therefore who will be responsible for the payments. In some cases, the investigation can lead to payments that the client is not happy with, and the company is not willing to budge. The difference shall arise when the client feels they were not paid enough, while the insurer feels they have done the best under the circumstances. This is why there are forensic services providers available. They rely on their expertise to find out the true cause of the incident and present these facts clearly.
There is no shortage of case where their services are applicable. They will be there when you find most of your clients saying you acted in bad faith. You will notice that clients will come prepared with legal representation, tasked with proving that the claim was unfairly denied, that you were not awarded as per the signed contract provisions unfairly, or any other way to show that your treatment was unfair when compared to a similar one that was reasonable.
Without the best forensic investigation looking into the incident, it shall be easy to prove all that. There shall be a case to answer when they show that you unreasonably denied or delayed a claim, or that you did not take the right steps in investigating the case. They shall also have a heavy case against you if they can show that you interpreted the wording of the contract only as far as allowing you to deny the claims resented before you. It gets worse if they argue that you refused to settle a claim for a client in full as per the contract, with no adequate justification.
There is no shortage of incidences where clients are trying to defraud insurance companies through wrong claims. They have led to severe losses for insurance companies on the past due to their numbers. They have further added to the need for proper forensic investigations services, to make sure that nothing underhand is going on.
There are rights that clients have when they enter such contracts. The company also has its share of rights that should not be taken advantage of. IT is when there is a poor investigation job done that these rights will be in jeopardy. This does not mean that there are no good actors in the industry, as there are many cases that go off without such hitches. You thus need these services, to root out any remaining cases of fraudulent claims attempts.