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Which Insurance Claims Are Investigated By an Insurance Investigator for Uncovering the Frauds?

An insurance investigator works with an insurance firm to make sure that the claims submitted to the firm are relevant and valid. Some investigations are done as a routine practice, while some investigations are conducted if the firm suspects that a particular person or group is submitting a false claim.


Why private investigators are a better option for investigating insurance claims?

Although some insurance firms may conduct investigations on their own, but without a professional approach, they might not get to the real facts, and that is why hiring a professional insurance investigator is a viable option to uncover the facts completely as they are experts in carrying out detailed investigation. These private investigators can be hired individually or through a private investigation firm; the latter being the more reliable option.


How does the investigator conduct the fraud investigation?

The investigators employ several methods and tactics to uncover the truth and facts behind the claims:


Verifying the claim by surveillance
Insurance analysis
History and medical reports search
Background check of the claimant
Analysis of previous claims
Witness interviews
And more such techniques


What insurance frauds are investigated by investigators?


Life Insurance

Investigators reveal the facts to determine if the claim is filed for a person who is still alive, along with checking on those who claim too much compensation.


Health Insurance

Investigators search and analyze billing records and check whether the health care is paid for. They also check if the doctors are not scheming with patients in any fraudulent activity.


Home Insurance

The investigators analyze the damage to discover the disaster fraud, along with investigating property fraud suspects completely. They also look into if the coverage was upgraded before filing for the claim.


Car Insurance

The investigators work to find the truth behind a car theft, along with identifying if the accident was staged by the claimant to file damage claims.


Workers Compensation

Many a times, workers claim compensation when, in fact, they are not injured and fake their injury. The investigators check on them and other related facts to bring forward the facts. The investigators also determine if the injury was caused at the workplace or not. For such compensation claims, the corporate firms may also conduct corporate investigation services on their own if they think that the worker is filing a false claim.


This way an insurance investigator finds the facts behind several insurance claims, and make sure that no fraudulent way is used to file for claims. An investigator not only works to identify false claimants, but they also work towards uncovering bad business practices at insurance companies, if the firm is not paying the compensation to the valid claimant.