Red Flag ≠ Evidence
Why suspicious indicators should generate investigative questions—not predetermined conclusions.
Read Field Note →The Claims Field Guide is a practical resource for workers' compensation adjusters, SIU professionals, TPAs, and carrier teams who need to move from suspicion to defensible investigative strategy.
Not another vendor blog. The goal is simple: give claims professionals useful guidance they can apply to a live file, a referral decision, an investigative plan, or a difficult conversation.
Why suspicious indicators should generate investigative questions—not predetermined conclusions.
Read Field Note →Referral checklists, planning worksheets, question frameworks, and report-review aids built for claims and SIU workflows.
View the toolkit →Public-source research and industry analysis translated into what it may mean for investigations, claims, and SIU practice.
Explore research →“A good investigation does not begin with a service order. It begins with a clearly defined question the evidence needs to answer.”
When surveillance is appropriate, how to improve timing and objectives, and how to avoid treating surveillance as a default response to suspicion.
Developing witnesses, sequencing interviews, preserving employer information, and building a fact pattern that helps claims professionals evaluate compensability.
Separating indicators from evidence, framing investigative hypotheses, and developing documentation that can withstand scrutiny.
Preparing for statements, identifying information gaps, developing follow-up questions, and recognizing when an interview should lead to additional investigation.
A companion body of work focused on moving workers' compensation fraud investigations from initial suspicion toward objective, documented evidence.
Explore the project