Audit, Accounting & Risk Management Services

Investigative & Adjusting

Service Overview

Experienced and reliable Investigative Service firms must be engaged early in the process to properly evaluate claims exposures. Investigators who have a proven track record with major insurers should respond quickly, gathering factual data to evaluate liability and damages. If litigation is involved, it’s critical to preserve evidence through photographs, statements, and police reports. The Investigative Services practice is comprised of both staff adjusters and a network of highly-trained independent adjusters, fully licensed and qualified to perform a variety of insurance claims investigations, including fraud, liquor liability, auto, premises liability, and other related investigative work. Typical insurance investigation clients include insurance carriers in the United States, international insurers and syndicates, law firms, and companies with Self-Insured Retentions (SIRs).

Services Performed

  • Conducting investigations, interviewing insureds, witnesses and claimants, and securing signed or recorded statements
  • Supplying photography and prepared accident scene diagrams
  • Obtaining medical authorizations and/or reports and verification of lost wages on bodily injury claims
  • Evaluating damages and providing specific settlement recommendations
  • Negotiating settlements directly with claimants or attorneys
  • Arbitration and litigation support including expert witness testimony

Additional materials

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Sample Engagements

Condominium Association Claim

A claim was brought against an insured condominium association alleging that a plaintiff fell off a deck while leaning against a handrail that became dislodged. During the course of the investigation, Alan Gray LLC’s staff adjuster determined that the plaintiff had actually fallen from a ladder into the handrail. Based on the investigation, a nominal settlement was negotiated by the client.

Liquor Liability Claim Successfully Denied

A liquor liability claim was brought against an insured restaurant after a motor vehicle accident occurred in which the driver was charged with operating under the influence of alcohol and seriously injuring the driver of another vehicle. The intoxicated driver pled guilty, stating that he consumed alcohol at the insured’s restaurant. Alan Gray LLC’s staff adjuster located and interviewed several witnesses who confirmed the guilty driver had not been at the insured restaurant on the night of the accident. The establishment where the driver had consumed alcohol was identified and placed on notice of their potential liability. The claim against the insured restaurant was successfully denied.

Irregularities Detected with Water Damage Claim

During the course of a special investigative assignment, Alan Gray LLC’s staff adjuster met with an insured and was given several invoices citing work done for a substantial water damage claim. After closer inspection, several irregularities were detected and the contractor named on the documentation was located and interviewed. The contractor admitted he did not complete the work as submitted and signed a statement for the adjuster. The investigation resulted in the claim being denied, saving the client a significant amount of money.

Service Professionals

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Our professionals

We have assembled an expert team of professionals whose industry experience encompasses all aspects of insurance, reinsurance, and capital markets services.

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