Insurance Claims

How to Protect Your Business from Fraudulent Claims

False claims cost insurance companies billions of dollars per year. Left unchecked, fraud can spread from the consumer claims throughout the company. It could be aided by an unchecked agent writing policies. Sometimes, the care practitioners are involved, such as doctors, chiropractors or other people in positions of trust.

Unraveling the deceit within a fraudulent claim requires a series of preliminary planning as well as extensive follow-up:

  • Upfront Planning
  • Diligent Surveillance
  • Review of Claim Documents
  • Investigation of Loss Indicators
  • Statements from Witnesses
  • Online and Computer Investigations
  • Background Screenings
  • Comprehensive Reporting

Investigating the ‘Claims’ Made in Insurance Claims

Santoni Investigations accesses all of its investigative tools to mitigate and uncover insurance fraud for its clients. We support insurance carriers, TPA’s (Third Party Administrators) and self-insured as they handle claims involving:

  • Workers’ Compensation
  • Property, Auto-Liability
  • Premises Liability
  • Product Liability
  • Construction Defect.

Our experienced investigators work with claims examiners, adjusters, claims managers, SIU and defense counsel on a daily basis to come up with strategic and cost-effective solutions to obtain the evidence needed to fight fraud or to negotiate and settle claims.

Here’s a list of some of the services the insurance industry relies on us to provide:
  • Surveillance
  • Activity Checks
  • Insurance Claims Reports
  • Subrogation
  • Clinic Audits
  • Interviews/Statements
  • Insurance Claims Report (similar to ISO)
  • SIU InvestigationsInsurance icons
  • Background Checks
  • Locates/Skip-Trace Investigations

Call us today for a complimentary consultation to set up a plan for your next investigation:

(949) 900-3400

  • Surveillance

    Injured workers that are fraudulently collecting benefits from your company or your insurance company can cost you dearly.Your premiums will increase...

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  • Interviews/Statments

    We work with clients and their attorneys to provide useful information during a time of uncertainty. When clients come to us they are typically...

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  • Background Checks
    Background Checks

    Our motto is “Trust But Verify” and this can be accomplished by conducting due diligence background checks. Before you take on...

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