from their worker's compensation or disability claims adjuster/examiner is a complete copy of
The Claim Notes or Adjuster's Notes on the Claim(s) under investigation
The
claim notes on a file or companion files of the claimant can be a
treasure trove of information that a claims investigator can utilize in
process of their investigation. Information for interviews or for
surveillance. Among the things the investigator may learn by reviewing
the claim's notes are:
- Summaries of interviews taken
by the adjuster with the claimant, witnesses, the employer, and/or
medical providers which contain representations being made by each party
in relation to the claimant, the incident, and/or the injury.
- Current disability/medical treatment status.
- When
was the last time the adjuster or claims personnel had contact with the
claimant, the employer, a witness, the medical provider(s).
- Is there any legal representation on the file?
- Are payments being provided to the claimant?
- Is the claim accepted, denied, or partially denied?
- What body parts are accepted and what parts are denied?
- Possible notation of prior claims history of the claimant.
- The
adjuster's summary and current and past plans of action. Where is the
adjuster directing the claim towards? What is the goal?
- Is there a third party or product that caused or contributed to the incident and resulting injuries? Who is the third party?
- What injuries is the claimant claiming?