Worker’s Compensation Clients

February 5, 2020
Valerie McGilvrey

I have a simple solution for the critical question private investigators ask, “How do we get direct work from insurance companies?” 

I want to teach you everything I know, not as a skip tracer, but as a former Texas Property and Casualty Insurance Adjuster. Flipping through study material to renew my license reminded me of the conversations I’ve read where investigators wrote about the struggle to reach this client base.

Worker’s compensation claims aren’t the only claims that underwriters hire private investigators for. When I worked for an agency, fraud claims accounted for about 30% of reassigned claims to my independent adjusting firm. Surprisingly, even with simple homeowner claims, I’ve experienced an element of fraud. 

The common-sense approach was not necessarily to prove that a claim was fraudulent, but prove that it was authentic and a covered claim and if I wasn’t able to do that on my own, I used a private investigator. Because I was authorized to pay claims $250,000. and above, I was authorized to spend a larger sum of file money on investigations. 

The most popular type of fraud during my years of working claims was exotic and luxury auto theft, I can attest that it’s still a go-to for easy money with con artists. It’s easier to recover these vehicles now, more than ever before, due to the number of license plate recognition cameras strapped to repossession spotter cars and tow trucks. Collateral recovery is my specialty and I’ve embraced the daily challenge of locating skips who skip often. 

Scarcity of marketing resources has stonewalled opportunities for investigators, even with referral sites such as Claimsdex.com and Claimspages.com, you need to be able to get to the insurance adjuster that works fraud and workers comp claims and has the power to authorize hiring a private investigator. 

Looking through sites that market to adjusters you’ll see certification classes offered for many different topics. Catastrophe, software, property certifications and bodily injury are classes where hundreds of adjusters emerge to get their continuing education and certificates. Here the atmosphere is relaxed and you can shake hands, exchange cards and have their full attention. 

Obtaining your state list of licensed insurance adjusters for a direct mailer could work for a state with a lower population. The downside is that you’ll never know if an adjuster is traveling or if they’re even currently working, also you won’t have any idea what kind of claims they adjust. I’m skeptical about mailing with a state list. I’ve spent thousands of dollars in printing and postage and didn’t get even one new client, I believed it was targeted marketing and it turned out to be an expensive bad date at the post office. 

It’s not impossible that you could call your local insurance offices and find out who the head of the office is and give that person your business cards to pass out to the department adjusters. I’ve never heard of anyone actually doing that and it’s very likely that you’ll be intercepted by a receptionist, but it’s worth a try. Personally, I never returned a phone call unless it was directly related to a claim. Adjusters are bombarded with hundreds of phone calls in a day and calling anyone else is not on the menu.

Another way to find adjusters that are likely to be full time would be to search for civil cases in your local courts. Any case with an insurance company as a plaintiff or defendant that’s in litigation with an individual wouldn’t be a subrogation suit. Not that you would hit a dead end by searching those files for statements or other involvement by a staff adjuster, but those are filed against companies to recover money paid on a claim, those adjusters won’t be likely to hire private investigators. Subrogation department adjusters only do subrogation litigation. 

Searching Pacer.gov could be a strong source for leads, Looking through case files may be easier than in years past due to files scanned and made available online either free or very low cost. If you spend less than $15.00 in one billing cycle, you won’t be charged anything at all. 

Typically, there’s one adjuster and possibly one supervisor who’ve signed reports and are listed as witnesses, if a claim goes beyond the financial limit of an adjuster’s power to authorize payment, another adjuster takes over the claim giving you one more adjuster to reach out to.

I believe it’s a better deal to go in person to view files, but I’ve seen these cases be entirely available online and if a case wasn’t viewable online, you can request it and the county would pull the file and scan and upload documents for public view. Most counties don’t charge for viewing or downloading documents that are not certified, which makes the only expense for targeting active adjusters be your time.