The Investigation Referral Is Not an Order Form

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A referral may say, “Conduct two days of surveillance,” “Locate and interview the witness,” or “Complete a social media investigation.”

Those instructions identify a service, but they do not always explain the question the investigation is supposed to answer.

That distinction matters.

An investigative referral should authorize the work, but it should also begin a conversation. The claims professional understands the claim, its history, its potential exposure, and the decision that must be made. The investigator understands what information can realistically be developed, what evidence may disappear, and which methods are most likely to produce useful results.

The strongest investigations bring those perspectives together before significant time and money are spent.

When a referral is treated like an order form, everyone may complete exactly what was requested and still fail to answer the most important question. When it is treated as a shared investigative plan, the work becomes more focused, proportionate, and defensible.

Start With the Decision

The first question should not be, “Which investigative service should we order?”

It should be, “What are we trying to understand or decide?”

For example, an adjuster may request two days of surveillance because a claimant has reported severe mobility limitations. The real question, however, may be whether the claimant is capable of driving, shopping, lifting, or performing work-related activities.

That objective changes the plan.

If the claim file shows that the claimant has a medical appointment on Wednesday morning, beginning surveillance on two random weekend days may not be the best use of the authorized time. If social media posts indicate that the claimant coaches a youth sports team every Thursday evening, that information may identify a better opportunity for observation. If preliminary research reveals an active contractor’s license and a business address, the investigation may need to focus on possible employment rather than general activity around the residence.

The service requested was “surveillance,” but the objective determines when, where, and how that surveillance should be conducted.

The same principle applies to witness interviews. A referral stating, “Interview the store manager,” provides a task, but not necessarily a purpose. Is the investigator trying to confirm when the incident was reported? Determine whether the condition existed before the accident? Identify other employees who were working? Preserve testimony before the witness leaves the company?

Without that context, an investigator may complete the interview but overlook the very facts the claims professional needed.

Investigators should never substitute their personal judgment for the claims professional’s authority. However, an experienced investigator should be willing to explain when a different method, sequence, or timing is more likely to accomplish the stated objective.

Share the Facts That Change the Plan

An investigator does not necessarily need every document in the claim file. The investigator does need the information that could materially affect how the assignment is conducted.

For surveillance, that may include:

• A recent photograph of the claimant
• Confirmed addresses and known vehicles
• Employment or business information
• Reported physical restrictions
• Upcoming medical appointments or legal proceedings
• Known travel or recurring activities
• Prior surveillance results
• Information suggesting the claimant is aware of the investigation

Small details can have a major operational effect.

Consider an investigator assigned to begin surveillance at 6:00 a.m. The referral includes an address but no vehicle information. After several hours, the investigator learns that the claimant’s vehicle had been parked two houses away and left the neighborhood before surveillance began. The investigator was technically at the correct address, but the assignment was compromised because a known vehicle was not included in the referral.

In another case, a claimant may live in a gated community with only one controlled entrance. If the investigator knows that in advance, alternative observation points or follow-up methods can be considered. Discovering it only after arriving may result in lost time and limited visibility.

The same is true of witness investigations. If a witness previously gave a recorded statement, the investigator should know that before conducting a follow-up interview. If the witness is a former employee involved in litigation with one of the parties, that relationship may affect how the interview is approached and how the information is evaluated.

For a digital investigation, useful facts may include known usernames, email addresses, telephone numbers, relatives, associates, prior locations, business names, and relevant dates. A common name without additional identifiers can produce hundreds of possible profiles. A known email address or former city may be the detail that allows the investigator to identify the correct person.

The investigator also has a responsibility to review the information provided and identify material gaps before work begins. A five-minute clarification at the beginning of an assignment can prevent hours of unproductive work later.

Match the Scope to the Exposure

Not every claim requires the same investigative depth.

The scope should be proportionate to the financial exposure, disputed issues, available leads, likelihood of litigation, and potential value of the evidence.

Consider two claims involving reported shoulder injuries.

The first is a lower-exposure claim involving a narrow dispute about whether the claimant returned to recreational activity. A focused social media review and one strategically selected surveillance date may be sufficient.

The second involves a catastrophic injury allegation, substantial future medical exposure, ongoing disability payments, and anticipated litigation. That claim may justify background research, preservation of online evidence, multiple surveillance dates, witness development, and coordination with defense counsel.

Both claims involve a shoulder injury, but they do not require identical investigative plans.

More investigation is not automatically better. The goal is to obtain enough reliable information to support the next claim decision.

Exposure should also help establish sensible stopping points. Suppose an investigator is authorized for three days of surveillance to determine whether a claimant is working at an auto repair shop. On the first day, the investigator confirms the claimant arriving in work clothing, opening the business, interacting with customers, moving equipment, and remaining at the location throughout the day.

That evidence may justify additional surveillance to establish a pattern, but it should also trigger a conversation. Continuing without an update simply because more hours were authorized may add cost without adding proportional value.

The opposite may also occur. Preliminary research may reveal that the claimant owns several businesses, uses multiple addresses, or recently transferred assets. Those findings may support expanding the investigation, but the investigator should explain the significance of the new information and obtain authorization before exceeding the approved scope.

Deadlines Are Part of the Investigative Strategy

Deadlines should be communicated when the assignment is made—not after the work is underway.

A mediation, deposition, reserve review, benefit decision, trial date, or statute-related deadline can determine which leads deserve priority and whether certain methods remain practical.

Investigative time is not interchangeable.

Imagine that an adjuster requests an interview with a former employee who witnessed a workplace accident. The referral notes that the report is needed in 30 days, but it does not mention that the witness is moving out of state at the end of the week. That fact changes the urgency of the assignment.

The same issue arises with digital evidence. A claimant may publicly post photographs from a weekend trip that appear relevant to reported restrictions. If the investigator waits several weeks to begin the assignment, the posts may be deleted, restricted, or made private. Even when information can later be recovered, early preservation usually provides a clearer record of what was publicly available and when it was observed.

Physical evidence can disappear as well. A damaged vehicle may be repaired, sold, or destroyed. Security video may be overwritten. A business may close. Nearby witnesses may relocate or forget important details.

The requested delivery date should also reflect how the information will be used. If defense counsel needs the findings to prepare for a deposition, delivering the report the night before may technically satisfy a deadline but provide little practical value. The investigator needs to know not only when the report is due, but what event is driving that date.

Define the Questions the Report Must Answer

A useful investigative report is not simply a record of what the investigator did. It should provide reliable information related to the questions identified at the beginning of the assignment.

“Conduct surveillance” describes an activity.

More useful questions might include:

• Is the claimant engaging in activity that appears inconsistent with the reported limitations?
• Is the claimant working, operating a business, or regularly visiting a suspected workplace?
• Can the claimant be positively identified?
• Is the reported residence information current?
• Are there observable patterns that would help determine whether additional surveillance is warranted?
• What prevented observation, and what options should be considered next?

These questions guide deployment, documentation, and reporting.

They also help the claims professional evaluate the result. An investigation does not become unsuccessful merely because it does not produce dramatic video.

For example, surveillance may establish that the claimant no longer lives at the address provided. A witness investigation may determine that the only reported independent witness did not observe the accident. A digital investigation may establish that a suspicious profile belongs to a different person with the same name. Surveillance may also document several days of limited or no observable activity.

None of those results may produce a dramatic “gotcha” moment, but each one narrows the issues and helps determine the next step.

Negative findings must also be explained carefully. “No activity observed” does not necessarily mean “the claimant never left the residence.” It may mean the investigator did not observe the claimant during the authorized period. A defensible report distinguishes between what was observed, what was not observed, and what could not be determined because of environmental or operational limitations.

Communication Should Continue After the Referral

The initial referral establishes the plan, but the plan must be allowed to respond to new information.

Investigators should communicate promptly when:

• Material facts change
• A useful lead develops
• The authorized method is unlikely to answer the question
• Continuing would create unnecessary cost
• Additional work may be justified
• Safety, legal, or access concerns affect the assignment

Suppose surveillance is authorized at a residential address. On the first morning, the investigator learns that the claimant moved three weeks earlier. The assignment should not simply continue at an outdated address so the investigator can complete the authorized hours. The claims professional should be notified, and the available options—such as an address update, database research, neighborhood inquiry, or revised field plan—should be discussed.

Communication must work in both directions.

A new medical appointment, deposition testimony, settlement conference, change of address, updated restriction, or newly identified vehicle may completely change the value and timing of an investigation.

These updates do not require lengthy meetings. A short, focused communication can:

• Identify the new development
• Explain why it matters
• Present reasonable options
• Confirm the authorized next step

That communication also creates a clear record of why the investigative plan changed.

A Better Referral in Five Parts

A well-constructed referral can usually be organized around five elements:

• Objective: The claim decision, disputed fact, or investigative question the work should support.
• Exposure: The financial or litigation significance of the issue and why it matters to the claim.
• Known facts: The current information that could affect timing, investigative methods, safety, identification, or access.
• Deadline: When the information is needed and what event or decision is driving that date.
• Authority: The approved scope, budget, reporting expectations, and circumstances requiring additional authorization.

A referral using those elements might read:

The claimant reports being unable to drive or lift more than 10 pounds following a shoulder injury. The claim involves ongoing temporary disability payments and a deposition scheduled in three weeks. The claimant has a medical appointment Wednesday at 9:00 a.m. and is believed to assist at a family landscaping business. Please conduct preliminary research and up to two days of surveillance, with the first day coordinated around the medical appointment. Notify the adjuster before exceeding the authorized time or changing the investigative scope. Provide an initial update within 24 hours of each surveillance date and the final report at least one week before the deposition.

That referral does more than order surveillance. It gives the investigator enough context to build a plan, recognize relevant activity, manage the budget, and deliver the information when it can still be used.

Collaboration Produces Better Evidence

Claims professionals should expect investigators to do more than accept an assignment and return a report. Investigators should ask thoughtful questions, identify missing information, explain realistic limitations, protect the client’s budget, and recommend changes when the facts justify them.

Investigators must also recognize that the claims professional owns the claim decision. The investigator’s role is to develop and document facts objectively—not to determine coverage, decide compensability, or exceed the authorized scope.

The best results occur when both parties understand their roles and communicate early.

An investigation referral should not be viewed as a product selected from a menu. It is the beginning of a fact-development strategy. When the claims professional explains the decision that must be made—and the investigator helps determine the most effective way to develop the necessary evidence—the investigation becomes more than a completed assignment.

It becomes useful, proportionate, and defensible.

Author Bio:

Justin D. Hodson, CPI, is the founder and CEO of Hodson P.I., LLC, a nationwide private investigation firm supporting claims professionals, attorneys, and organizations. With more than 20 years of industry experience, Justin was named the California Association of Licensed Investigators’ 2024 Investigator of the Year. His leadership has helped shape Hodson P.I.’s strategic approach to providing reliable investigative findings and court-defensible reporting that support informed client decisions.