Many things can go wrong in life, which is why people have insurance policies. You need to have them in pace to sort you out when you suffer loss, even for property. Before payment is made, it has to be clear who was responsible and therefore who will be responsible for the payments. Some of these incidences can get so complicated that it is not easy to tell who was responsible and therefore who needs to pay. The difference shall arise when the client feels they were not paid enough, while the insurer feels they have done the best under the circumstances. This is why there are forensic services providers available. Their job is to get to the cause of the incident and present their findings in a manner clear to all.
There are many cases where these services are applicable. They help to clear the air when clients start assaying you acted in bad faith. There is the expectation that the clients will have lawyers, hired to show that the claim was unfairly denied, that you were not awarded as per the signed contract provisions unfairly, or any other way to show that your treatment was unfair when compared to a similar one that was reasonable.
If you do not have the case investigated properly, that will not be hard to prove. There shall be a case to answer when they show that you unreasonably denied or delayed a claim, or that you did not take the right steps in investigating the case. They shall also have a heavy case against you if they can show that you interpreted the wording of the contract only as far as allowing you to deny the claims resented before you. It gets worse if they argue that you refused to settle a claim for a client in full as per the contract, with no adequate justification.
There are many cases of clients trying to defraud insurance companies. They have led to severe losses for insurance companies on the past due to their numbers. They have further added to the need for proper forensic investigations services, to make sure that nothing underhand is going on.
There are rights that clients have when they enter such contracts. The insurance firm also has to safeguard its rights in such an agreement. IT is when there is a poor investigation job done that these rights will be in jeopardy. This does not mean that there are no good actors in the industry, as there are many cases that go off without such hitches. You thus need these services, to root out any remaining cases of fraudulent claims attempts.