LDA SERVICES

Health Claims Investigation

Health insurance is one of the most common policies worldwide—and sadly, some individuals attempt to exploit it with fake or exaggerated claims, even going so far as to falsify serious events. Our seasoned investigators have a proven track record of uncovering fraudulent medical claims and protecting insurers from unnecessary payouts. With Medi‑claim frauds on the rise and losses mounting daily, our dedicated team brings methodical, on‑ground verification to every case.

• Verify the medical necessity for claimed services by auditing detailed treatment records—covering dates, locations, treating providers, services rendered, and medicines, supplies, or equipment issued—to confirm actual expenses
• Conduct careful interviews and cross‑check billing summaries with prescriptions, service provider details, and all supporting documents to validate every line item
• Detect and expose ‘ghost patients’ and identity disguises; when required, deploy discreet insurance surveillance to establish the truth
• Identify lack of medical necessity where claimants feign illness or obtain illegitimate support from medical practitioners
• Authenticate all certificates and prescriptions directly with issuing authorities to rule out forged or fabricated paperwork

Personal Accident Claim Investigations

Personal Accident insurance is essential for small business owners who aren’t covered by Workers’ Compensation. Just like Workers’ Comp, insurers must proactively manage compliance with laws and entitlements. Our team conducts thorough PA claim investigations to establish the facts, validate entitlements, and identify fraud or recovery opportunities.

• Obtain the general facts and full circumstances of the claim
• Identify negligent parties and opportunities for third‑party recovery
• Conduct Work Injury Damages enquiries and gather required processes
• Confirm financial records to verify claimed entitlements
• Organize and take formal statements from injured employees and employer witnesses
• Gather policies and procedures; capture photo/video evidence; perform worksite visits and assessments
• Run surveillance where symptoms appear exaggerated; verify restrictions outside the workplace and detect fraudulent activity
• Perform desktop investigations for quick, specific outcomes: telephone interviews; online database searches (insurance, residency, voting, business records); social media searches; and confirmation of previously provided information
• Execute skip‑trace/witness location to identify or locate witnesses—even years later when staff have moved on
• Start skip‑traces with minimal inputs: full identity details (name, date of birth, last known address, employment) and the required level of discretion

Motor Accident (MACT) Claim Investigations

Under Section 165 of the Motor Vehicles Act, 1988, Motor Accident Claims Tribunals (MACT) adjudicate compensation for death, bodily injury, and third‑party property damage arising from the use of motor vehicles. Third‑party claims are among the most challenging to investigate—our specialists apply proven field practices and meticulous verification to establish facts and support fair outcomes.

• Verify the insured’s full and current address
• Record the date, time, and exact location of the accident
• Establish the detailed circumstances of the accident
• Document injuries and, where applicable, the cause of death
• Perform motor vehicle crash analysis
• List all treating physicians and hospitals with names and addresses
• Capture details of police or other authorities who investigated, including the names and identifiers of investigating officers
• Obtain autopsy/post‑mortem reports and hospital medical records, including the Medical Examiner’s details
• Take witness statements; conduct site visits and prepare scene diagrams
• Verify death certificates and related records
• Secure copies of police proceedings (e.g., FIR, statements, panchnama, charge sheet)

All findings are compiled into a clear, evidence‑referenced report to support timely, defensible claim decisions.

Own Damage (OD) Claim Investigations

OD claim evidence is built primarily from on‑scene documentation and detailed vehicle inspections. It’s critical to preserve and record the accident scene before weather, time, or human activity alters the evidence. Our investigators move quickly to secure facts and create a defensible reconstruction.

• Document scene fluids and debris: puddles of gasoline, oil, or blood; glass, fender fragments, and shredded or blown tires
• Record skid, scrub, and gouge marks on pavement, ground, and nearby fixed objects
• Measure distances from the point of impact to final vehicle rest positions
• Note indicators of alcohol or drug use present at the scene
• Collect and log private property ejected from vehicles at impact
• Conduct comprehensive vehicle inspections to assess damage patterns and mechanical condition
• Capture establishing photographs: full scene, approaches, and fixed reference objects for scale and location
• Capture 360‑degree photographs covering north, south, east, and west perspectives
• Capture detailed damage photographs of vehicles and any struck items
• Determine pre‑ and post‑impact directions of travel
• Measure pre‑impact skid lengths and post‑impact distances moved
• Assess friction levels for all surfaces traversed by the vehicles
• Establish point of impact, impact angles, and vehicle weights for analysis

All findings are compiled into an evidence‑referenced report with measurements, diagrams, and photographs to support accurate OD claim decisions.

Workmen’s Compensation Investigations

Workmen’s Compensation insurance covers an employer’s statutory liability for employee death, disability, or injury arising out of and in the course of employment, as provided under the Workmen’s Compensation Act (Ministry of Labour & Employment). Our investigations help verify the legitimacy of claims and ensure obligations are met fairly and lawfully.

• Conduct discreet surveillance (audio/video) to assess whether reported limitations align with observed activities
• Interview colleagues, friends, and family—and conduct desk research—to identify potential fraud indicators and their extent
• Verify medical, employment, and related records; check for patterns of prior compensation claims or employer misclassification
• Gather and preserve evidence that supports legitimate claims or exposes fraudulent ones, enabling appropriate action

We compile clear, evidence‑referenced reports to support defensible decisions—either validating rightful benefits or curbing fraudulent claims.

Marine Claims & Accident Investigations

Our investigators bring deep practical experience and technical knowledge across marine claims and accident investigations, including high‑profile casualties. We know rapid response is critical for preserving evidence in the first hours of an incident—especially when claims follow. Our team is available 24/7/365 to deploy quickly and secure the facts.

• Collisions, groundings, and damage to fixed or floating objects—including extent of damage, causation, and liability
• Hull & Machinery damage assessments
• Expert Witness services with support for litigation, mediation, and arbitration
• Recording of witness statements
• Personal injury investigations
• Analysis of nautical‑based claims
• Loss Prevention consultancy
• Heavy weather investigations

Fire Claim Investigation

Fire insurance protects policyholders against loss or damage due to fire from multiple sources—electrical faults and gas explosions, lightning, and certain natural disasters. Depending on the policy, damage from burst or overflowing water tanks or pipes may also be covered. Our fire investigations focus on preserving scene integrity and maintaining a defensible chain of custody for all evidence.

• Document the location of evidence with written notes, sketches, photographs, photo/video logs, evidence recovery logs, tags, and container labels
• Collect evidence from areas of origin (e.g., first fuel ignited and ignition source) in suspected non‑accidental fires
• Place evidence in labeled containers for transport and preservation; immediately seal liquid evidence in clean, unused, vapor‑tight containers (e.g., new paint cans, glass jars, or lab‑approved nylon/polyester bags)
• Label each container with unique identifiers: investigator name, date/time, case number, sample number, description, and location of recovery
• Package evidence according to laboratory policies and procedures
• Recognize and preserve other physical evidence—bloodstains, footwear impressions, latent prints, and trace evidence—using proper collection methods

Theft Claim Investigation

Theft claims are often difficult to prove. Our dedicated team is experienced across formats of theft claims and verifies every aspect with vigilance to establish authenticity. The key to exposing fraudulent theft claims is recognizing suspicious factors early and investigating them thoroughly.

• Size of the loss
• Type of property stolen
• Circumstances of the loss
• Timing of the loss
• Loss history and background
• Police reports
• Documentation of the loss
• Insured’s statement
• Scene examination
• Witness statements

Travel Insurance Claim Investigation

Fraud isn’t limited to organized rings—individuals may attempt travel insurance fraud for reasons ranging from financial pressure to perceived harmlessness. Our investigators assess the full context of each claim and verify travel details to detect inconsistencies and prevent fraudulent payouts.

• Confirm dates of travel
• Validate identity documents submitted for tickets
• Verify departure and arrival details
• Confirm mode of travel (train, bus, flight)
• Verify accommodation arrangements at the destination
• Cross‑check overall tour duration and itinerary

Death Claim Investigations

Life insurance safeguards families when a primary earner passes away—covering critical expenses such as burial, taxes, and education, and helping dependents regain stability. Insurance fraud undermines this protection. Knowingly providing false, incomplete, or misleading information is a crime and can lead to denial of claims and prosecution under applicable laws. Our investigations establish the facts with diligence and integrity.

• Background histories
• Contestable investigations
• Disappearance inquiries
• Evidence documentation
• Fraudulent claims investigations
• Homicide‑related inquiries
• Interviews and statements
• Medical records review
• Public records searches
• Surveillance and activity checks
• Verifications