The 8th Thing That A Claims Investigator Needs…

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?