A Case Shows The Specialization

From the history of human development, we can see it is the division of labor that leads the collapse of the original clan and the dying out of primitive society. And today, with the rapid development of economy, the division of labor in society becomes clear. With the development of insurance industry, the division of the profession related with it has been embodied. Under the force of this tide the claims investigation emerges in China. Steele, the first company that deals with the claims investigation in China mainland and under the authorization of the Industry and Commercial Administration, has abundant experiences about claims investigation.

From the following case, we can see the specialization of Steele about claims investigation.

On May.8, 2002, a fax from a foreign insurance company came to Steele. It said that: an insured had come to death in Beijing. They supplied us a brief introduction of the case, a certification of death, which didn't show the cause of the death, and the invoice from the funeral home. And they required an investigation on the spot.

After receiving the fax, Steele drew out two plans for the case:
Plan A, investigating on the spot: including visiting related person and organization; inquiring the cause of death; checking the medical history of the decedent; checking the authenticity of the materials; verifying the background of the family and its economic condition; verifying the information about the decedent's hospitalization and economy; getting the photograph of the spot; analyzing and advising about the case.

Plan B, besides all of Plan A, also including expert's analysis and authentication. It is made up of four parts: about the treatment (the medical history and presence disease); about the medicine (the rationality of the examination, diagnosis, treatment, and the prevention measure); about the relations (the logic and rationality of the response of the family); about the materials (verify the authenticity and validity of the materials). At the same time, it also provides authentication given by criminal expert and it includes authentication in written materials, authentication on contingency, and authentication on forensic pathology.

Finally, the company selected Plan B. So after affirming of the commission, Steele organized investigators to work.

After receiving the case, our investigators analyzed it and made a particular plan. Then they began the investigation on May.10. They took it in Beijing and Guangzhou.

Due to the faint clues, investigators in Beijing visited Tian An Men Police, Gu Gong Police, and the direct center of Beijing Public Security Bureau at Tian An Men. All of above lies in Qian Men area where is the place that the insured came to death. But there weren't any records at all. Then our investigators contacted the Detective Unit of Beijing Public Security Bureau. From there they got the information that a hotel had reported a case about the insured's death. The investigators got in touch with the hotel immediately. But the hotel couldn't give detail information about it due to its rules. Nevertheless we knew that the insured had been lived here and had been sent to hospital from here after the accident.

At the same time, good news came from Guang Zhou that the flight, which the insured had boarded, had been checked out. The insured traveled to Beijing with a tourist group. And a travel agency organized the group. Through the travel agency we got the details of the accident and the place the insured was sent to.
The investigators in Beijing then visited two first-aid stations in Beijing. After twist and turns, our investigators got the emergency records of the insured at one first-aid station. According the records, the investigators got that the insured was sent from the hotel by car and when they got there, the insured had been dead, and the cause may be toxicosis. Then the decedent was sent to Beijing Forensic Authenticate Center to do an identification of the death.

After visiting the Beijing Forensic Authenticate Center, the investigators got the true cause of the death.

Then our investigators went to the funeral home to check out the information about the funeral and got some information of the family.

Thus, the investigation in Beijing came to an end. Investigators in Guangzhou verified the identification of the decedent, visited the insured's work place, verified the identification of the policy holder, visited the work place of the policy holder, and found out the economic information of the family. Then our investigators came together to make a conclusion that the insured's death didn't belong to the insured range.

Finally we gave a report to the insurance company that included comprehensive and impersonal records of the investigation, collection of some written materials; photographs of the spots, and our advices and suggestions.

Through our investigation, we checked out the fact of the accident and gave peace in mind to the insurance company. The company was very satisfied with our work.

Through the case, we can see that Steele has a nice work system and a group of efficient investigators. The investigative program shows the specialization on claims investigation of Steele. We believe that Steele will become more specializing, supply better service to our clients, and offer more to the work of claims investigation to decrease the risk of insurance companies