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When Do Claims Adjusters Investigate Personal Injury Claimants?

Personal injury lawyer-Samer habbasInsurance adjusters in Orange County personal injury claims rely on certain “red flags” to alert them to the possibility of fraud. When they see these signs, they are much more likely to put those particular claimants under surveillance. Some of these signs may seem silly, but claims adjusters have been known to act on them.One such sign is if the adjuster at any point sees the claimant in athletic wear. This may seem like a silly reason to be suspicious; after all, many people wear athletic wear for style or comfort rather than exercise. Nonetheless, adjusters may suspect claimants of exercising, which may not be possible if they were injured.

Another common sign that can raise adjuster suspicion is a claimant’s involvement in previous claims. Adjusters are always on the worried about being “gamed” and may suspect you of being a “serial claimant.” If the claimant had the same doctor or attorney for these previous cases, they may suspect the claimant of being part of some sort of claims mill that defrauds insurance companies.

This particular suspicion may lead to the adjuster searching for the claimant on a central database. Many large insurance companies subscribe to a service called the Central Index Bureau, which maintains a database on all claims made with other subscribing insurance companies. While a lengthy claims history is no real proof that a claimant is defrauding or has ever defrauded an insurance company, personal injury attorneys can expect significant resistance during negotiations if the adjuster finds a record.

One last cause of claimant suspicion is the claimant’s medical history. If the claimant has had similar types of injuries in the past, the claims adjuster may begin to suspect the claimant of trying to “milk” a preexisting injury for a settlement. Claimants will begin looking for alternative causes for your current suffering, including possible “reoccurrences” of symptoms from your previous injury.

Many of these factors can turn up entirely by coincidence in completely legitimate claims. This is part of why any personal injury claimant in Orange County needs an experienced Orange County personal injury attorney on their side. Call Samer Habbas today at (888) 848-5084 for a free initial consultation.