INSURANCE CLAIMS INVESTIGATION CHECKLIST

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--- INITIAL CLAIM RECEIPT & ACKNOWLEDGEMENT ---
[ ] Claim Received Date
[ ] Claim Received Time
[ ] Claim Reference Number
[ ] Claim Intake Method (Online Portal, Phone, Mail, Agent)
[ ] Notes on Initial Contact/Receipt
[ ] Claim Status (Initial) (Open, Acknowledged)
[ ] Claim Processor Signature

--- POLICY VERIFICATION & COVERAGE ASSESSMENT ---
[ ] Policy Number
[ ] Policy Effective Date
[ ] Policy Expiration Date
[ ] Coverage Type (Homeowners, Auto, Commercial, Life, Health)
[ ] Policy Limit
[ ] Deductible Applied (Yes, No)
[ ] Deductible Amount
[ ] Notes on Coverage Review

--- DAMAGE DOCUMENTATION & EVIDENCE GATHERING ---
[ ] Photos of Damage (Front)
[ ] Photos of Damage (Back/Details)
[ ] Description of Damage
[ ] Location of Damage (GPS Coordinates)
[ ] Quantity of Damaged Items
[ ] Date of Damage
[ ] Time of Damage

--- LIABILITY DETERMINATION (IF APPLICABLE) ---
[ ] Primary Negligence Party (Claimant, Insured, Third Party, Unclear/Further Investigation Needed)
[ ] Description of Incident
[ ] Witness Statements (If Applicable)
[ ] Estimated Damages Caused by Negligent Party
[ ] Contributing Factors to Accident (Speeding, Distracted Driving, Weather Conditions, Mechanical Failure, Other)
[ ] Date of Incident Report Filed

--- COVERAGE VERIFICATION & POLICY INTERPRETATION ---
[ ] Policy Type (Homeowners, Auto, Commercial, Life, Health)
[ ] Specific Policy Language Review Notes
[ ] Endorsement Status (No Endorsements, Endorsement Present)
[ ] Endorsement Details (if applicable)
[ ] Coverage Limit
[ ] Policy Effective Date
[ ] Exclusions Applied (None, Flood, Earthquake)

--- ESTIMATE REVIEW & VALIDATION ---
[ ] Estimated Repair Cost
[ ] Actual Repair Cost
[ ] Estimate Source (Contractor, Public Estimator, Insured's Choice)
[ ] Estimate Accuracy (Accurate, Slightly High, High, Low)
[ ] Notes on Estimate Discrepancies
[ ] Supporting Documentation (Photos, Invoices)
[ ] Estimate Received Date
[ ] Deductible Applied

--- FRAUD INDICATORS ASSESSMENT ---
[ ] Claimant Relationship to Insured (Claimant is the Insured, Claimant is a Family Member, Claimant is a Business Partner, Claimant is a Third Party)
[ ] Suspicious Circumstances (Unexplained Delay in Reporting, Conflicting Statements, History of Prior Claims, Significant Injury or Loss, Vague or Inconsistent Narrative)
[ ] Prior Claims in Last 5 Years
[ ] Narrative Summary of Suspicious Activities
[ ] Professional Involvement (No Professional Involvement, Attorneys Involved, Public Adjuster Involved, Contractor Involved)
[ ] Date of Initial Incident Report

--- REGULATORY COMPLIANCE & REPORTING ---
[ ] Reporting Deadline
[ ] Reporting Jurisdiction (Federal, State, Local)
[ ] Claim Count Reported
[ ] Summary of Reporting Activity
[ ] Supporting Documentation
[ ] Reporting Form Used (Form A, Form B, Custom Form)
[ ] Submission Date

--- SETTLEMENT AUTHORITY & APPROVAL ---
[ ] Settlement Amount Proposed
[ ] Settlement Authority Level Required (Level 1, Level 2, Level 3, Legal Review Required)
[ ] Date of Settlement Approval
[ ] Approving Manager Signature
[ ] Approval Comments/Justification
[ ] Settlement Type (Full Settlement, Partial Settlement, Denied)

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