OIC Investigation Procedures & Methods 2 — Questions and Answers
Question 1: When documenting a scene during an insurance fraud investigation in Oregon, which method best establishes the chronological sequence of events?
- Interviewing the claimant first
- Creating a timeline log with timestamped photographs and notes (Correct answer)
- Filing a police report immediately
- Notifying the Oregon Division of Financial Regulation
Correct answer: Creating a timeline log with timestamped photographs and notes
A timestamped timeline log with photographs creates a defensible chronological record of investigation findings.
Question 2: Under Oregon insurance investigation guidelines, when is it appropriate to conduct surveillance on a claimant?
- At any time without restriction
- Only after obtaining a court order
- When there is reasonable suspicion of fraudulent activity and the activity is in a public space (Correct answer)
- Only with written consent from the claimant
Correct answer: When there is reasonable suspicion of fraudulent activity and the activity is in a public space
Oregon investigators may conduct surveillance in public spaces when there is reasonable suspicion of fraud, without a court order.
Question 3: A recorded statement from a claimant during an Oregon insurance investigation is MOST valuable because it:
- Can be used to immediately deny the claim
- Locks in the claimant's version of events for comparison with other evidence (Correct answer)
- Satisfies the statutory reporting requirement
- Replaces the need for a written statement
Correct answer: Locks in the claimant's version of events for comparison with other evidence
Recorded statements preserve the claimant's account verbatim, enabling investigators to identify inconsistencies if the story changes.
Question 4: Which of the following sources is typically LEAST reliable when corroborating a claimant's injury in a workers' compensation investigation?
- Independent medical examination results
- The claimant's own social media posts (Correct answer)
- Treating physician records
- Co-worker witness statements
Correct answer: The claimant's own social media posts
Social media posts can be taken out of context and may not accurately reflect the claimant's medical condition.
Question 5: During a field investigation of a suspected arson claim in Oregon, the investigator should FIRST:
- Enter the structure to collect evidence
- Coordinate with fire investigators and law enforcement before entering (Correct answer)
- Interview neighbors about the fire
- Review the policy for coverage limits
Correct answer: Coordinate with fire investigators and law enforcement before entering
Investigators must coordinate with fire and law enforcement agencies first to preserve the chain of custody and ensure legal access.
Question 6: An Oregon insurance investigator discovers that a claimant's medical records contain altered dates. The BEST immediate action is to:
- Confront the claimant directly
- Discard the records and obtain new ones
- Document the alterations and refer findings to the Special Investigations Unit (SIU) (Correct answer)
- Approve the claim to avoid liability
Correct answer: Document the alterations and refer findings to the Special Investigations Unit (SIU)
Altered records are potential evidence of fraud and must be documented and escalated to the SIU for proper handling.
Question 7: In Oregon, the primary purpose of an Examination Under Oath (EUO) in an insurance investigation is to:
- Settle the claim out of court
- Obtain a sworn, detailed statement from the insured under penalty of perjury (Correct answer)
- Replace the recorded statement already taken
- Notify the claimant of claim denial
Correct answer: Obtain a sworn, detailed statement from the insured under penalty of perjury
An EUO is a contractual right that compels the insured to provide a sworn statement, which can be used in legal proceedings.
OIC Investigation Procedures & Methods 2
When documenting a scene during an insurance fraud investigation in Oregon, which method best establishes the chronological sequence of events?