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-24 HR EMERGENCY AOE/COE
-14 DAY SURVEILLANCE TURN AROUND
SERVICES
-SURVEILLANCE
-AOE/COE INVESTIGATIONS
-SOCIAL MEDIA INVESTIGATIONS
-SIU SERVICES
-ACTIVITY CHECK
-DATABASE SEARCHES
-CIVIL INVESTIGATIONS
SURVEILLANCE
Employers and insurers bear the burden of proof regarding any false allegations and misrepresentations. Thus, the most important aspect of our service is to bring transparency to the case.
It is said, "A photograph is worth a thousand words". INSIGHT SUBROSA holds that to be true through feedback we receive from our clients.
Surveillance investigation assists claims adjusters in a variety of areas:
. Compensability issues in the first 90 days that involve confirming and verifying injuries and/or accidents or other extenuating circumstances
such as dual employment.
. Limits body parts through capturing true physical abilities.
. It may effect a change in the doctor's opinion, thus stopping TTD benefits and/or lower permanent disability depending on the stage of the case.
. May question the nature & extent of consequence claims, especially for psychiatric injury claims.
. Unquestionable evidence gives the claims adjuster the tool to position the claim to a quicker settlement, thus diminishing exposure to further disability payments and prolonged.
We go the extra mile with timely turnaround, clear communications, and high quality evidence.
AOE/COE Investigations
Workers' Compensation law requires insurers, self-insured employers and third party administrators to determine compensability on claims in the first 90 days of report. Executing on that timeline takes experience. INSIGHT SUBROSA has investigated thousands of claims and gained the experience required for these challenging investigations.
Our investigators have proven skills in various types of claims and their respective information collection. We have experience in the following types of investigations:
. AOE/COE investigations - Mechanism of injury whether there is a specific injury, continuous trauma injury, repetitive stress injury, aggravation and apportionment.
. Casual Employment - Various employment types such as volunteers, independent contractors, sponsored sports activity, coverage and contribution issues on shared liability.
. Subrogation - Where injury or injuries arise from a motor vehicle accident, a defective or malfunctioning machine, or other party responsible for the injury or injuries.
. Intoxication, substance abuse, altercations or horseplay - Require immediate investigation. We will gather information from witnesses before valuable information and time are lost.
. Going and Coming rule and special errands - We will inquire the accident location and obtain all accident or injury information as well as any deviations.
. Post termination claims, personnel actions, sexual harassment allegations, discrimination claims (132a) and Serious and Willful Misconduct allegations.
Our expert investigators will obtain written or recorded statements in a swift manner so business is not disrupted. We will take photographic evidence to preserve the evidence. In some cases we may obtain signed medical releases, secure police reports, and preserve any evidence that may be sensitive.
Our investigators do not waste any time collecting evidence; as memory, manipulation by third parties and even legal counsel can deteriorate actual accounts. We emphasize efficiency and swiftness on our turn-a-round time. Our standard target date is 14 days.
SIU SERVICES
$80 billion a year.
That is the cost of workers' compensation fraud. INSIGHT SUBROSA provides some relief with SIU services that counteract fraud.
Everyone in our field takes pride and a massive sense of accomplishment when we crumble an entire fraudulent practice. Whether a medical group with six offices of fraudulent activity, totaling $200 million in lost claims or John Doe who moved to seven cities and filed four worker's compensation claims under four different names; INSIGHT SUBROSA brings these fraudulent claimants down.
Working alongside several of California's largest, most complex Worker's Compensation leaders and also staying connected to the smaller insurance carriers who balance our system, INSIGHT SUBROSA remains well connected to the basic needs of SIUs.
INSIGHT SUBROSA conducts simple to intensive investigative services for SIUs. Figuring out the pieces to your puzzle is our mission. We fill in the blanks with hard evidence. Backed by 25 years of investigate services and an uncompromised network of resources, accurate results come quickly.
Big picture? We bring down health care cost. A noble cause.