DiCarlo Associates LLC

                                    Security Consultants & Private Investigators

 

Worker's Compensation Claims

 

 

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         The worker’s compensation claim is the fastest growing type of claim filed against an employer's various insurance carriers.  However, the nature of those claims is changing.  We are no longer in the midst of our country’s industrial revolution; a period that produced serious easy to identify injuries.  We are now well into our nation's information age which produces more soft tissue injuries, called “strains and sprains”, and stress related conditions that are harder to detect and identify.  These obscure claims require more, not less, outside investigation.  Employers, particularly self-insured employers, can waste time and money by relegating the claim process to phone calls and faxed questioners or investigations conducted by non-skilled personnel.  Employees can spot gaps in the system that are favorable to fraudulent claims or claims that drag on unnecessarily.  On site investigations conducted by professional independent outside sources will create an atmosphere that will discourage fraud and control expenses!  

Preliminary investigations (Usually conducted within 3 days of reported injury)

  • Site visit (within 50 miles)

  • Statement of victim

  • Medical record release form

  • Photos of injury site and physical injuries

  • Job description documentation

  • Supervisor interview

  • Up to 3 witness interviews

  • Professional report

  • Package cost - $350.00

 

Options (may be applicable to employers or insurers ~ Hourly rate applicable)

  • Coverage investigation

  • This option is designed to reveal facts relating to jurisdiction, overlapping coverage, multiple employments, separation of duties and responsibilities in joint venture situations.

  • Factual investigation

  • Details of who, what, when, where, why, and how relating to the injury (some information included in preliminary investigation)

  • Insured’s investigation

  • This option produces details of the employment relationship between the insured and the claimant, about the insured and insured’s claim history, alternate coverage, and training issues.   

  • Claimant’s investigation

  • Details about the claimant’s background, dependencies, and medical progress.  

  • Medical investigation

  • Details relating to the providers of medical care; qualifications of medical professionals, doctor’s records relating to the claim, hospital records, progress of recovery, autopsy reports, and rehabilitation progress.

Arizona License #1003885