About Our Life & Health Claims Services
Investigating life claims can be a complex task which must be handled with empathy and respect. At G4S Compliance & Investigations, we are ever mindful of the protocols and requirements needed when handling all claims and particularly claims of a sensitive nature. 

The range of Life, Health and Income Protection Policies available today require an intimate knowledge and clear understanding of policy conditions and definitions. 

At G4S Compliance & Investigations, we provide that expertise. 

However, all too often, many claims do not warrant the compensatory benefit payable under the terms of the policy. Our success at uncovering fraudulent death and disability claims is well documented, both domestically and internationally. 

At G4S Compliance & Investigations, the knowledge and expertise we offer to our clients adds immediate value to any investigation. The methodical approach, detailed analysis and informed investigative facts and decisions we deliver to our clients helps them make the right choice when resolving the claim. 

Our Life Claims Investigations Encompass:

• Contestable & Non-Contestable Death Claims
• Beneficiary Interviews
• Media & Newspaper Searches
• Police Interviews & Record Verification
• Hospital & Emergency Service Interviews
• Verification of Certified Medical Records
• Medical Examiner & Coroner Inquiries
• Collection of Documentation
• Witness Location & Interviews
• Scene Inspection & Photography
• Funeral Home, Burial & Gravesite Services

Our Health Claims Encompass:

• Application & Policy Investigations
• Claimant & Witness Interviews
• Broker Interviews & Investigations
• Medical Record Release & Collection
• Neighborhood Canvass
• Alive & Well Checks
• Surveillance
• Hospital & Medical Checks

 

Life & Health Claims Service Descriptions

Many companies that manage long-term disability claims, will consider special handling outside the scope of the policy provisions when it is deemed that a claimant’s maximum recovery will not change the status of the claim. These claims may be placed on automatic payment status or their Proof of Loss provisions waived. 

As an important service offering, G4S Compliance & Investigations Investigators meet with the claimant and gather information that will either validate or raise questions about whether special handling is still warranted.

Recovery Evaluations
In the event that a claimant of Life or Health Benefits is overpaid by the company, the challenge of assessing repayment options can be difficult. While we are not involved in debt collection, we can gather financial and social information that will assist the insurance professional in making the appropriate decision.

Special Investigations
Through our automated CaseTrak system, our experienced staff of investigators are scheduled for brief assignments or lengthy, detailed investigations taking weeks or even months. We have extensive experience and contacts with local, state, and federal authorities and can coordinate or direct complex investigations throughout the United States and in more than 90 countries around the world.

Special Services
G4S Compliance & Investigations partners with all of our clients in the Life & Health industry and since we have extensive experience with claim settlements, claim litigation, fraud analysis and reporting, trend analysis and customized solutions we can actively assist our clients in achieving significant and successful outcomes which are world class.

International Investigation Services
G4S Compliance & Investigations has investigated Life and Disability Claims on every major continent and we have an inherent, understanding of the process and undertakings required for a successful outcome. Whether it’s investigating a suspicious death claim in Africa, interviewing a beneficiary in Pakistan or a verifying a death certificate in Vietnam, we have the expertise and coverage to quickly and comprehensively facilitate any investigation.

Death Claims
On contestable life claims, our investigative efforts are focused on determining the insurability of the deceased during the contestable period reflected in the provisions of the policy. Our investigators are fully trained on beneficiary and employer interviews; the procurement and analysis of records and forms; and the follow-up of all developed leads.

Health Claim Investigations
Designed to focus on developing information concerning the prior health of the claimant, information may be gathered through pharmacy records, medical records or physician interviews. In situations where provider fraud is suspected, we conduct detailed practice audits and can coordinate with attorneys, and local or federal law enforcement if necessary.

Waiver of Premium Claim Validation
An often overlooked service that can be vital to Life and Disability Insurance Companies, our investigators will focus on validating claims with provisions that waive premium while the insured remains disabled. Unlike services that focus on potential fraud indicators, our investigators seek to validate the disability to ensure that the claimant is eligible for premium waiver on an ongoing basis.

Occupational / Impairment Specific Interviews
We have designed a library of interview templates and questionnaires to ensure we gather the most relevant and detailed information during the interview process. Questions are specifically tailored to be occupational and impairment specific, so the final report submitted by the investigator reflects comprehensive, relevant, and detailed information that is needed by the claims handler.

To learn more about our Life & Health Claims Services, please contact us today.