Investigation of Claims

Investigation of Claims

Investigation of Claims

Summary

Insurers may undertake factual and/or medical investigations.

Key Information

Factual Investigation

Statements may be requested by an insurer‑appointed investigator. A support person can attend; request a draft for review before signing. Invasive surveillance may warrant complaints.

Independent Medical Examination (IME)

Attendance may be required in limited circumstances; workers may be entitled to choose from three doctors.

Referral or Escalation

Do a legal referral to review draft statements, address surveillance concerns, or clarify IME requirements and doctor selection.

Practical Tips

  • Be cautious with social media; content can be evidence.
  • Request time to review any statement before signing.
  • Provisional Liability
  • Denial of a Claim
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