Did you know that fraud may steal $80 billion a year from insurance companies? In fact, 21 percent of bodily injury claims and 18 percent of personal injury protection claims involved some sort of fraud or buildup.
Due to this dilemma, there are times in the claims handling process when insurance adjusters become skeptical of claims. When this occurs, an insurance company may turn to a medical background investigation team to help shine a light on a claimant’s injuries, prior medical history and treatment received.
Why Is Medical Canvassing Necessary?
Medical canvassing is a lengthy research and analysis process that is designed to uncover pre-existing illnesses and claims. This analysis can help you more accurately determine a claimant’s history of medical treatments and uncover incidents of attempted fraud.
Although plaintiffs deserve their chance to pursue compensation for injuries, there are bad apples who may withhold information about their past or current treatments. These individuals may be selective when deciding what information to share with insurance companies.
By using medical canvassing, we can help our clients obtain a bigger picture of where and when a claimant received medical treatment and whether undisclosed pre-existing conditions could be involved.
What Are the Benefits of Medical Canvassing?
Our investigators identify specific, geo-targeted medical facilities in the area to find out when and where a claimant may have received medical treatment in the past. Additionally, we often target facilities outside of a claimant’s current geographic area based on other factors including utilizing our proprietary tracking system for doctors who specialize in plaintiff work or who have been known to be investigated for fraud.
We can search in the radius of the claimant’s home or current employer. Our investigators also routinely look at facilities located near prior addresses going 10 years before the date of incident. We can assist insurance providers with disability, workers’ compensation and bodily injury claims.
Our medical canvassing team can help insurance providers with the following:
- Determining if the claimant received treatment prior to the accident.
- Verifying if the alleged injuries are not part of any pre-existing injuries.
- Determining if a claimant has a history of injury claims.
- Determining whether injuries occurred outside of the workplace.
- Uncovering treatments that were not previously disclosed.
- Uncovering a pattern of drug-seeking behavior.
- Substantiating a claimant’s statements.
- Revealing possible material misrepresentations about the claim.
- Providing specific information about treatments received for pre-existing conditions.
Medical Background Investigations
Bosco Legal Services, Inc. provides comprehensive medical background investigations to provide an in-depth analysis of a patient’s medical history, illnesses, injuries and claims. We help insurance companies and businesses protect themselves from fraudulent claims and buildups by uncovering the evidence they need. Our services are HIPAA compliant and all of our searches are conducted by highly trained and skilled investigators.
Contact Our Medical Background Investigators
Since 1988, Bosco Legal Services, Inc. has assisted law firms, insurance companies and businesses with investigating claims. If you need help gathering medical evidence or uncovering potentially fraudulent claims, contact the medical background investigators at Bosco Legal Services, Inc.