Red Flags in Medical Records What Insurance Adjusters Look for When Evaluating Your Injury Claim

• June 20, 2022

M any insurance companies have departments dedicated to investigating injury claims for their validity. Insurance investigators often become suspicious when there’s something about the
claim that “doesn’t seem right” under the facts and circumstances presented. If this happens, it may prompt a further inquiry into your claim.

As a personal injury claimant, it’s always in your interest to avoid having your case marked for such an inquiry … even if your claim is 100% genuine. If the insurance company’s investigation results in the discovery of something problematic about your claim, rest assured this will be brought to the attention of the court at an appropriate time. This could result in you having to provide an explanation or clarification to clear up the issue, which can in turn have the effect of delaying or prolonging your case.

Fortunately, most claims are not subjected to this rigorous kind of investigation. In fact, your claim probably won’t receive any unwanted special attention from an insurer unless one or more of these “red flags” are present