Claim investigation gathers the facts bearing on liability and damages: scene documentation, statements from the insured, claimant, and witnesses, police and incident reports, photographs, and medical and wage records.
It runs alongside but is distinct from coverage investigation, which examines the policy.
Alternative Names:
Claims Investigation, Liability Investigation
Why it Matters?
The adequacy of the investigation is itself a bad faith issue, since unfair claims practices statutes require a reasonable inquiry before denying or valuing a claim. Investigations that reach a conclusion before gathering the available evidence, or that pursue only facts supporting denial, are the fact pattern in most first-party bad faith verdicts. Documenting what was sought as well as what was found protects against that characterization.
Frequently Confused with
Related terms
Frequently asked questions
What makes an investigation unreasonable?
How does claim investigation differ from coverage investigation?
