Bid category: Consultants and Professional Services
Bid number:TBD
Bid title:Insurance Investigations – AOE/COE
Insurance Investigations – Sub Rosa
Bid due:Due to J. H. Askins Company, Inc. prior to October 12, 2007
Phone:(415) 468-0330
Prospective bidder, J. H. Askins Company, Inc. seeks HRC-certified LBE subcontractors in the following trades: Insurance Investigation – AOE/COE and Insurance Investigation – Sub Rosa. Contact Joe Askins at (415) 468-0330, .
Description:Investigation Services – AOE/COE
The Workers’ Compensation Division may request an AOE-COE investigation to determine whether an injury arose out of and occurred during the course of employment (AOE/COE). Investigations may include: review of assignment documents; review of WC claims file/documents if appropriate; initial conference (in person/phone) with adjuster identify background information including work location and environment, standard duties and responsibilities, typical work routines, employment status and wage information; conduct background research including Merlin-type data search, DMV search etc.; obtain statements (recorded) from the injured worker, supervisor(s), department personnel representative, co-workers, witnesses, and/or other involved parties; respond to any new information/issues that arise during the investigation with appropriate action, including follow up questions and/or further investigation; provide prompt, clear and concise written reports and evidence documentation; will provide regular status reports to examiner by phone or in writing; all services will be provided in accordance with all applicable legal codes and statutes.
If subrogation issues are identified during the initial investigation (or fraud is suspected), a more thorough investigation will ensue. This effort may include the following procedures: Identify all parties involved; identify all insurance company(s) for all parties; obtain written and signed statements from persons with material information regarding the claim; obtain signed releases for medical and outside records; obtain all medical, personnel records and/or civil court records.
Description:Investigation Services, Sub Rosa
The Workers’ Compensation Division may request Sub-rosa investigation be conducted to ascertain the nature and/or extent of a Workers’ Compensation injury, or if there is reasonable suspicion of potential fraud. Investigations include: preliminary, demographic and background research; active surveillance with frequent verbal reports to examiner; provide timely written reports and copies of video tapes and attach any/all research documents; all services will be provided in accordance with all applicable legal codes and statutes.
In all cases, written reports of activities shall accompany invoices for services. Investigators may be required to testify and produce video/surveillance tapes at the Workers’ Compensation Appeals Board, in depositions, and/or in Superior Court for criminal cases.
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