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claims investigation checklist
Initial Assessment
Review the claim notification and any initial documentation.
Contact the claimant for a preliminary discussion.
Verify the claimant's policy details and coverage.
Determine if the claim is within the policy period.
Identify any potential red flags or indicators of fraud.
Documentation and Evidence Gathering
Request detailed documentation from the claimant.
Collect any relevant third-party reports or statements.
Gather photographic or video evidence if applicable.
Obtain police or incident reports when necessary.
Consult with experts or specialists for technical assessments.
Evaluation and Decision Making
Analyze the collected evidence for consistency and accuracy.
Assess the extent of the damages or loss.
Determine the liability and coverage based on policy terms.
Review any legal or regulatory considerations.
Make a decision on the claim and document the rationale.
