Insurance Investigators: 5 Keys To A Successful Fraud Investigation

Insurance investigators can be new to some people, and at the same time, it not new to some people; between 2018 and 2028, the insurance investigator career is expected to grow 4% and produce 13,000 job opportunities across the U.S.

According to our findings, it shows that insurance investigators make an average of $25.8 an hour? That’s $53,664 a year!

What Does an Insurance Investigator Do

Many skills require for the insurance investigation to accomplish their responsibilities. Looking at some resumes makes us narrow down the most common skills for a person in this position.

When looking at some crucial skills required to be an insurance investigator, we discover that many resumes listed 37.8% of the insurance investigators included insurance companies, as 8.1% of resumes included liability claims, while 6.2% of resumes had medical records.

How can I become an insurance investigator?

If you are interested to be an insurance investigator, you need to know how much education you need.

Our research shows that about 48.6% of insurance investigators have a bachelor’s degree. 17.4% of insurance investigators have master’s degrees in higher education.

Insurance Investigator Job Duties

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Every job has duties, and the insurance investigator’s responsibilities vary according to the severity and nature of the suspected fraud or criminal activity. These include:

  • Using conducting surveillance to obtain background and personal information on claimants
  • Interviewing claimants and witnesses
  • By getting oral and written statements
  • By taking photographs for evidence
  • Safeguarding documents
  • Verifying public and private records
  • Inspecting buildings, vehicles, and personal property
  • Gathering and analyzing facts and developing evidence
  • Writing a broad details
  • Making a recommendations regarding the disposition of a case
  • Coordinating with outside experts, including forensics professionals

The insurance investigator’s work environment can be incredibly, and it can be spent traveling some days, while others are finished in an office.

Get this clear; an insurance investigator doesn’t work alone; they work for an insurance company by looking into insurance claims, like fraudulent claims.

You need to gather information from the insurance adjuster, witnesses, law enforcement, and the claimant. Then you have to investigate whether the claim is valid or fraudulent.

After all the investigation, your next job is to document all evidence and present the case to your employer for the insurance company to be protected from false claims.

Insurance fraud is totally a serious crime that costs advanced countries billions of dollars each year. But the main point is that if no citizen ever engaged in insurance fraud, then there is no how insurance companies would hire investigators.

5 Keys To A Successful Fraud Investigation

To carry out a successful fraud investigation, you will need some tips to follow to catch the fraudsters faster and recover funds. See some points below:

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Make an Investigation Plan

Making a plan is the best option and the first thing to do when conducting an investigation. It can be stressful and challenging, but once you have a plan to follow, it will be easy. 

An investigation plan should include:

  • The scope of the investigation
  • All parties involved in the investigation
  • Investigation activities, tasks, and their deadlines
  • The team roles and responsibilities
  • Risks to the investigation

With five points we listed can helps the investigation run smoothly and lowers your risk of making big mistakes.

Set up a hotline

This aspect is challenging because detecting fraud and figuring out when to start an investigation is one of the most challenging parts of the whole thing.

In that case, hotlines help employees to give tips about some bad behavior that you may have missed and can also confirm suspicious you may have, providing your investigation a strong start.

Use technology

Technology can be significant in detecting, investigating, and preventing fraud. Many insurance companies mostly use artificial intelligence to spot fraudulent claims.

Go undercover

Going undercover can easily make the investigation work out without too much stress. Hire an investigator for surveillance that will act as an undercover and reveal the fraudsters.

Understand your evidence

Getting fatal evidence help than wasting your time gathering unnecessary evidence that you can’t use. Try to separate the facts, inferences, and opinions. You can conduct a thorough, objective, and unbiased investigation if you understand the difference. 

Read more: 5 Reasons You Should Fall In Love With Finance Jobs

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