04 March 2019

What does an Insurance Fraud Investigator do?

As an Insurance Fraud Investigator, you help your employer determine if someone has filed a fraudulent claim for insurance money. These cases can take a variety of forms, from lost or stolen property that has been in the owner’s possession the entire time, to a car accident or injury that never really happened, and more. Fraudulent claims can cost an insurance company millions of dollars per year. An Insurance Fraud Investigator will work hard to uncover the truth, help keep costs down, and protect people who truly need insurance coverage.

Like any good Detective, as an Insurance Fraud Investigator, you rely on facts and data. This can come from many sources.

First, an Insurance Claims Adjuster or other staff member may notice an inconsistency with a person’s claim. Then it’s up to the Insurance Fraud Investigator, to determine a course of action for the investigation. Phone calls, emails, additional information requests to medical personnel-depending on the type of claim-are all standard investigative techniques. In addition to these standard techniques, the other methods such as surveillance, background checks, physical surveillance are also used to reach the facts.

You need good communications skills and an inquisitive mind to get the information you need out of the people you talk to. Some investigations may require significant travel, as you may need to survey the scene of an accident, or interview people close to the claimant to determine the veracity of their claim. Good organization helps you keep all the facts and figures straight in your head and on paper as you put together your final report.

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