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Workers' comp investigation

Workers' Compensation Claim Investigation for Carriers and Employers

Delator Claims Division investigates reported workplace injuries for workers' compensation carriers, self-insured employers, third-party administrators and the attorneys who represent them. The work establishes what can be verified about how, when and where the injury was reported to have happened.

Workers' Compensation Claim Investigation in Tennessee for insurance carriers
Workers' Compensation Claim Investigation for insurance carriers across Tennessee
Coverage
95 of 95 counties
Dispatch
24 / 7 / 365
Metro response
Under 60 min avg.
Statewide
4-hour guarantee
Overview

What this service covers

A first report of injury is usually a few lines long. It gives a date, a body part and a short account, often written by a supervisor who was not present. An investigation assignment fills in what that form leaves out: who was on shift, what task was underway, what equipment was involved, when the injury was first mentioned and to whom. Each point is tied to a source so the adjuster can see where it came from.

This service is retained by the paying side of the claim. It is not offered to injured workers or their attorneys. Field personnel are licensed Tennessee private investigators who gather facts through site visits, voluntary interviews and public-source research. The report states what was found and what could not be confirmed. Compensability, causation and benefit decisions remain with the carrier, the employer's program and their counsel.

When it is useful

Claims that usually prompt an investigation

  • An injury is reported on a Monday morning with no witness, and the account places it late in the previous Friday shift.
  • The description given to the supervisor differs from the history recorded at the first clinic visit, and the adjuster needs both accounts sourced.
  • A claim is filed shortly after a layoff notice, a disciplinary write-up or a denied leave request, and the sequence needs to be laid out.
  • The employer has several locations and nobody at the corporate level can say which machine, dock or line the report refers to.
  • Defense counsel wants the accident circumstances pinned to named sources and dated records before depositions are scheduled.
What the investigation covers

What the investigation covers

Accident account
The worker's reported version of events as recorded on employer forms, compared point by point with what supervisors and coworkers say they saw or were told.
Shift and task timeline
Time records, work orders and production logs supplied by the employer, arranged into a sequence covering the hours before and after the reported injury.
Reporting history
When the injury was first mentioned, to whom, in what words, and how long after the reported event, drawn from interviews and employer records.
Location walk-through
A visit to the work area with photographs showing the layout, distances and equipment referenced in the account, noted as it appears on the inspection date.
Public-source activity research
Open-source and public-records research into recreational, athletic or side-work activity around the injury date, limited to material anyone can lawfully view.
Open questions list
A plain list of points that could not be verified, records that were unavailable and people who declined to speak, so gaps in the file are visible.
How a deployment runs

From request to delivered record

  1. RequestCall dispatch or submit the request form with the location, loss type and urgency.
  2. DeployDispatch assigns the nearest available licensed field investigator through the statewide network.
  3. DocumentPhotographs, video, measurements and factual notes are captured once the scene is safe to work.
  4. PreserveFiles are timestamped, organized and kept in their original form with a record of who captured them.
  5. ReportThe package is delivered securely to the requesting party, typically the same day.
In detail

Why the first two weeks matter to the file

Details of a workplace injury fade quickly for ordinary reasons. Coworkers rotate to other shifts or leave the company. Camera systems overwrite footage on a fixed cycle. The pallet, ladder or tool involved gets moved, repaired or thrown out. Memory of who said what at the time of the report becomes less exact with each retelling. An assignment opened early captures those details while people can still describe them from recollection instead of from what they later heard.

Delator dispatches around the clock across all 95 Tennessee counties, with Routine, Rush and Emergency tiers. For a claim investigation, the first visit usually covers the site walk-through and the people most likely to become unavailable. Follow-up interviews and records research are scheduled after that. Findings are delivered securely to the requesting adjuster, risk manager or attorney, with photographs and interview summaries attached to the narrative report.

What the report says and what it leaves to you

The report separates three things: what a named person stated, what a document shows, and what the investigator personally observed. It does not blend them into a conclusion. Where two accounts conflict, both are set out with their sources. Where an account is consistent across every source, the report says so in the same factual tone. An investigation that confirms the reported account is as useful to the file as one that raises questions.

Delator does not decide whether an injury arose out of the job, does not offer opinions on medical causation and does not characterize anyone's honesty. It does not advise on how the claim should be handled under workers' compensation law. Those judgments belong to the carrier, the employer's program administrator and their attorneys. The investigator's job is to give them a factual record complete enough to support whatever decision they reach.

Scope of workCarrier-side service

This service is available to insurance carriers, self-insured entities, third-party administrators and the attorneys who represent them. Delator reports facts and observed indicators; decisions on coverage, liability, settlement and any fraud referral remain with the client.

It is not offered to policyholders or claimants, and Delator does not act as a public adjuster. Policyholders and claimants can request neutral scene documentation instead.

Questions

Common questions about this service

Who can request a workers' compensation claim investigation?

The service is available to workers' compensation carriers, self-insured employers, third-party administrators and attorneys representing them. It is not offered to injured workers or claimant attorneys. Requests are taken by phone at 615-977-9929 or by email, and the assignment is confirmed with the requesting party before anyone is dispatched.

Will the investigator speak with the injured worker?

Only when the requesting party asks for it and it is appropriate. If the worker is represented by an attorney, contact is handled as the client and its counsel direct. Any interview is voluntary, and a recorded statement is taken only with the person's consent stated on the recording.

What do you need from the employer to start?

The first report of injury, the names and shifts of people who were nearby, a site contact who can arrange access, and any time or production records the employer is willing to share. The investigator works from what is supplied and notes in the report anything that was requested but not received.

Does the report say whether the claim is legitimate?

No. The report sets out verified facts, conflicting accounts and unanswered questions. It does not label a claim valid or invalid and does not conclude that anyone acted dishonestly. The carrier, its special investigations unit and counsel draw their own conclusions from the record.

Tennessee coverage

Available statewide, including

Every Tennessee county is covered. See the deployment map for typical response tiers by county.

Request a deployment

Request documentation anywhere in Tennessee

Dispatch is staffed around the clock. For time-sensitive scenes, calling is fastest; the request form works for routine and scheduled assignments.