What are Activity Checks in Claims Investigations?

Claims investigations are often about verifying whether a claim aligns with real-world behavior. Activity checks are one of the most efficient tools investigators use early in that process.

According to the National Insurance Crime Bureau (NICB), 180,508 questionable claim submissions were handled in 2024 alone. Not every questionable claim turns out to be fraudulent, but that volume highlights why insurers rely on fast, targeted investigative steps before committing to more time and cost-intensive methods. Activity checks help bridge that gap.

How do Activity Checks Work?

Activity checks are a distinct, lower-level investigative tool used early in the claim review process to validate claimant activity and identify potential inconsistencies. They typically include short visits to a claimant’s home, neighbor interviews, and local verification of routine.

Consider a Workers’ Compensation claimant that reports a back injury, states they “can’t lift,” and indicates they are mostly homebound due to medical restrictions.

During a brief, lawful activity check, an investigator sees the claimant carrying groceries, loading items into a vehicle, performing yardwork, or commuting regularly. These are all activities that may be inconsistent with the reported limitations.

This doesn’t automatically mean fraud. However, it directly aligns with common Workers’ Compensation red flags such as injury exaggeration or working while out on disability, and it may justify additional review or escalation.

Activity Checks vs. Background Checks

While activity checks and background checks are often used together in claims investigations, they serve very different purposes and answer different questions.

Activity Checks: Verifying Present-Day Behavior

Activity checks focus on what a claimant is doing right now.

The purpose is to:

• Verify whether a claimant’s reported condition or limitations align with observable, real-world behavior
• Confirm basic claim details such as residence, daily routine, or physical activity level
• Help determine whether further investigation, such as surveillance, is warranted

Activity checks are typically:

• Short in duration
• Low intrusion
• Conducted early in the investigative process

They are designed to provide a snapshot of current activity, not a long-term record or evidentiary file.

Background Checks: Establishing Historical Context

Background checks, by contrast, looks backward.

The goal is to:

• Review a claimant’s history, not their current behavior
• Identify prior claims, employment records, address history, business affiliations, or other public-record information
• Provide context that may support or contradict claim statements

Background checks rely on:

• Public records
• Databases
• Prior claim or litigation history
• Open-source information

They do not assess whether a claimant’s present-day activities align with their reported injuries or restrictions.

When Should an Activity Check Escalate to Surveillance?

Not every activity check leads to surveillance. Common escalation triggers include:

• Observed activity that conflicts with medical or functional restrictions
• Inconsistencies between claimant statements and public records or online behavior
• Repeated schedule patterns suggesting undisclosed work or activity
• Prior fraud indicators combined with new observational discrepancies

When these elements converge, surveillance becomes a targeted next step rather than a speculative one.

Why Activity Checks Come Before Surveillance

Cost is a major reason activity checks are used as an initial investigative step.

According to pricing guidance published by Privin Network:

• Basic background or digital footprint checks typically range from $50 to $200+
• Surveillance costs often range from $90 to $300+ per hour, and can increase for complex or multi-day cases

It’s important to note that surveillance costs can escalate quickly if deployed without clear justification.

In claims investigations, activity checks are all about aligning claims with reality. With over 180,000 questionable claims handled in a single year, insurers and investigators need tools that are fast, cost-effective, and proportionate.

Used correctly, activity checks:

• Reduce unnecessary investigative spend
• Help validate legitimate claims faster
• Identify when deeper investigation is truly warranted

Strengthen your claims investigations with accurate, cost-effective activity checks. Talk to our team today.

Check out our sources:

National Insurance Crime Bureau. 2024 Annual Report. National Insurance Crime Bureau, 2025, https://www.nicb.org/annual-reports/2024.

Privin Network. “How Much Does It Cost to Hire a Private Investigator? A Comprehensive Guide.” Privin.net, 21 Oct. 2024, https://privin.net/how-much-does-it-cost-to-hire-a-private-investigator-a-comprehensive-guide/.