[Our services]
Claims Investigations
Objective facts for sound claim decisions.
Some claims need more than a desk review. TJS conducts claims investigations for carriers, adjusters, and TPAs, gathering documented facts that help you evaluate a loss on its merits.
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Speak to an Investigator (888) 600-0261
01. Overview
Independent fact-finding for questioned claims.
When details in a claim are unclear, inconsistent, or simply need confirming, field work can supply context the file lacks. TJS Private Investigations conducts claims investigations across liability, property, auto, and other lines, documenting what the evidence shows.
Our approach is neutral. A claims investigation is not designed to deny a claim; it is designed to establish facts. We report findings that support the claimant’s account as clearly as findings that raise concerns.
Claims that often benefit from investigation:
- Liability claims with disputed accounts of how an incident occurred
- Auto claims with questions about drivers, vehicle use, or circumstances
- Property losses where the cause or extent needs context
- Injury claims with reported limitations
- Claims where statements and records don’t line up
- Losses showing indicators that call for a closer look
- Claims where witnesses have not yet been identified
Carriers and TPAs can read about our wider work on the investigations for insurance companies page.
02. Capabilities
Field work matched to the line of coverage.
Scene and Area Canvass
Visit relevant locations to document conditions and identify potential witnesses or nearby sources of information.
Statements
Where appropriate and with the person’s consent, take statements from claimants, insureds, and witnesses and record them accurately.
Background Research
Review available records relevant to the claim, such as court filings, address history, and business affiliations.
Activity Documentation
Where a claim involves reported limitations, document observable activity in public settings through lawful surveillance.
Auto Claim Questions
Research matters such as household drivers, vehicle use, and where a vehicle is kept, using available records and field verification.
Structured Claim Reports
Deliver findings in a report that maps each piece of evidence to the questions in the referral.
03. Our Investigators
Neutral observers with field experience.
A claims investigation is only useful if the adjuster can rely on it. Our investigators document conditions as they find them, record statements in the person’s own words, and avoid conclusions the evidence doesn’t support.
TJS has more than 17 years of investigative experience and serves insurance professionals in 29 states and Washington, DC from its Houston, Texas headquarters. Claim files may be reviewed by supervisors, counsel, and sometimes the courts, so we write for that audience.
04. What Clients Receive
Findings mapped to your questions.
Depending on the claim type and the assignment, deliverables may include:
- A written report addressing each question in the referral
- Scene photographs and observations
- Statements taken during the investigation, where obtained
- Background and records research findings
- Photographs and video of observed activity, where assigned
- Identified witnesses and their contact details, where available
- A summary of consistent and inconsistent facts
Reports describe what was observed, said, and found in available records. Coverage, liability, and claim decisions remain with the carrier. Findings that neither confirm nor rule out a concern are reported as exactly that.
05. Why Choose TJS
Reporting adjusters can rely on.
Experienced
More than 17 years of field and research work, including insurance matters.
Objective
Findings that support the claim are reported as plainly as those that don’t.
Thorough
We work through the referral’s questions and flag related issues we notice along the way.
Clear Communication
Adjusters receive updates when significant developments occur, not only at the end.
06. How It Works
From referral to report.
- 01.
Send the Referral
Provide the claim details, the concerns, and the questions you need answered.
- 02.
Confirm the Plan
We agree on tasks, budget authority, reporting format, and any dates you’re working toward.
- 03.
Investigate
Investigators carry out the agreed field work, statements, and research, and update you on key developments.
- 04.
Deliver Findings
You receive the report and supporting materials for your claim review.
07. Frequently Asked Questions
What carriers and adjusters ask.
1. What types of claims do you investigate?
Liability, property, auto, injury, and other claim types. Tell us the line of coverage and the issues so we can match the work to the claim.
2. Will the claimant know an investigation is taking place?
It depends on the tasks. Statements and some scene work involve direct contact; records research and activity documentation generally do not. We discuss the approach before work begins.
3. Do you take recorded statements?
Where appropriate and with the person’s consent. We document who was present, when the statement was taken, and what was said.
4. What if the investigation supports the claim?
Then that is what we report. An objective investigation is valuable whether it raises concerns or resolves them.
5. How is a claims investigation different from SIU support?
A claims investigation answers the questions in a specific referral. SIU support provides ongoing capacity for a special investigations unit, often across many files.
6. Can you handle claims in other states?
TJS serves 29 states and Washington, DC. Share the claim locations and check our service locations, and we’ll confirm coverage.
08. Next Steps
Send us the questions that matter.
Send the claim details and the questions that matter to your decision. We’ll recommend a focused plan and confirm the scope before any work begins.
[Ready to start a conversation]
Decide the claim on documented facts.
Tell us what needs to be verified. We’ll explain how a focused claims investigation can support your review.
Speak to an Investigator (888) 600-0261
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