Insurance fraud investigation is a niche facet of the detective arts that encompasses several different career paths. Most private eyes, regardless of specialization, will come across some type of insurance theft case during their career.
Insurance theft is a serious crime in the world today, with criminals costing indemnity companies billions of dollars yearly. Of course, consumers are the ones who actually pay the price in the form of increased premiums to cover these tremendous losses.
This focuses discussion details insurance theft case profiles. We will explore the types of investigators often involved in insurance fraud cases and also explain how you can increase your presence in this very lucrative sector of the detective industry.
What is Insurance Fraud Investigation?
Insurance companies protect people and property from all manner of threats. Insurance can protect against property damage or theft, health, professional and business conduct and life itself. Private citizens usually have multiple insurance policies covering all aspects of their lives. Businesses might have even more coverage. The insurance sector is a gigantic industry with calculated risks. However, the one variable which can derail the industry is false claims.
Insurance theft is defined as making any claim that is exaggerated or untrue. People or businesses can inflate the value of their claims, committing fraud or may report false claims where no loss occurred at all, which is even worse fraud!
Fortunately, the insurance industry has many safety nets in place to catch and punish fraudsters. In fact, it is rare for a large or suspicious claim to ever be paid without some degree of investigation.
Insurance Fraud Detectives
Many different types of investigators can work on insurance theft cases, including all of the following types of detectives::
Insurance adjusters often seek out and uncover instances of inflated claims. They might also earmark suspicious cases as being potentially fraudulent and therefore subject to inquiries from their SIU units.
Special investigative units work for all major insurance companies. These skilled investigators will stop at nothing to find instances of insurance policy theft or exaggeration of claim value.
Many independent trial preparation investigators (like me!) will uncover instances of insurance claim fraud during litigation support. I worked as a defense investigation specialist for insurance counsel and was involved in many insurance fraud cases during my time working in New York City.
Insurance fraud is a criminal offense and this opens the door for police and other law enforcement investigators to get involved in this niche detective work. Once evidence of insurance fraud is found, criminal charges will be filed against the perpetrator.
Insurance Fraud Investigation Work
Most people who focus on any type of insurance investigation work are employed directly by the major insurance companies around the world. All manner of adjusters and investigators are well trained to recognize the signs of suspicious claim activity and seek answers to the question of potential fraud before green-lighting any claim payment.
Civil litigation investigators also are actively involved in fraud cases that may have been paid or not, but have resulted in some manner of settlement or trial proceeding. Know for sure that these investigators are some of the best in the business and are directly responsible for costing or saving their side huge sums of money during legal proceedings.
Police detectives will work closely with the above types of private sector investigators to punish those suspected of fraud and those who have been caught red-handed. Remember, insurance theft is always a crime and if you go down this dishonest road, someone is sure to witness your deeds and seek to put you behind bars. Insurance fraud is not a victimless crime. In fact, we all pay dearly for the criminal acts of a few heinous individuals.