What Does An Insurance Fraud Investigator Do?Not all insurance claims are valid and when an insurance company suspects that something is amiss they have an insurance fraud investigator take a look. These individuals are trained to look at a claim and investigate whether or not it's legitimate. These investigators work in every realm of the insurance world including auto insurance, health care fraud investigation as well as in the area of arson investigator. This is a challenging and interesting position.
One of the key areas that an insurance fraud investigator focuses on is the background and claim's history of the person filing the claim. Some people have a history of filing insurance claims and then once they've been settled, they move to another insurance company. A highly skilled insurance fraud investigator will look into a person's history and determine if they pose a risk for dishonest activity. Often times, a person who has been convicted of insurance fraud will use a fake identity to take out a new insurance policy. Insurance fraud investigators search for this kind of activity as well. In addition they take a hands-on approach when they suspect a claim has been filed that isn't genuine. This part of a fraud investigator's job often involves a lot of time spent out of the office, interviewing and gathering evidence. In the case of an auto collision where the company suspects illegal activity is taking place, the investigator will attempt to contact witnesses and also take photographs of the vehicles that were involved as well as the intersection. Another tool that many fraud investigators use is to determine the weather the night of the incident to see if it played a part and also to see if the claimant can recall it. If he or she can't this may be an indication of deception. A health care fraud investigation is often a detailed and extensive process. Many people go on long term disability benefits. This means the insurance company has to pay out a lot of money in ongoing claims. If there is any doubt about the legitimacy of the claim, the insurance company will put an insurance fraud investigator to use. In a case like this the investigator will not only interview the person who filed the claim but may also speak with their friends and neighbors. One of the ways that health care fraud investigation is undertaken is by following the claimant and documenting any activity that appears to contradict the claim. There is obviously a lot of responsibility placed on an insurance fraud investigator. They are often placed into difficult situations in which they must use their intelligence and intuition to determine whether someone is telling the truth or not. Insurance fraud investigators are often solely responsible for saving an insurance company a considerable amount of money. |