What is a Claims Examiner?

If you’ve been hurt on the job and are seeking compensation from your insurance company, it’s possible that you’ll come into contact with a Claims Examiner at some point. If you’ve truly been hurt while at work, there’s nothing to be alarmed about – this step of the process is normal. The Claims Examiner is there to make sure that your claim is based in truth and to ensure that there aren’t any red flags they should be aware of. For extra support and to make sure you’re doing everything the right way, consider hiring a disability lawyer, like the ones from Parmele Law Firm, to provide assistance.

What Does a Claims Examiner Do?

A Claims Examiner will process your insurance application for compensation. It’s their job to either reward or deny the claim. Before they make a decision, they’ll research your case to make sure the claim isn’t fraudulent. Claims examiners are adept at analyzing situations to make sure the claim should actually be rewarded. Claims Examiners must have specific certification in order to review claims and recognize when fraud is occurring.

Claims examiners aren’t just used in disability insurance cases, but also in bankruptcy fraud, tax fraud, money laundering, and consumer fraud. Various types of companies hire claims examiners in order to prevent both the business and its customers from losing money. On top of being certified, claims examiners also have in-depth knowledge of the company they’re working for.

How Are Claims Investigated?

When it comes to investigating a claim, the examiner has a lot of responsibilities on his plate. Ultimately, they need to make sure that the claim is legitimate and that the person who made the claim is providing the correct information. In this way, the examiner can tell apart people who truly need compensation from people who are just trying to cheat the system. The two most important responsibilities of a Claims Examiner are conducting private investigations and carefully reviewing documentation. Sometimes, the examiner will also place a business or individual under surveillance.

For people who are being honest in their claim, there’s nothing to worry about – compensation is there to help you. Claims Examiners have an important job because they help businesses save money that might otherwise be spent on fraudulent claims. In the end, this only helps those who truly need the compensation.

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