In the car insurance industry, though less amount of money is involved, incidences of fraud are more prevalent. Other insurance companies like fire insurance and theft usually would leave it to police as they are more capable of dealing with criminal activities.
Insurance Detectives are very much like private detectives, meaning they are not connected with the police or any government agencies, except that they investigate only insurance-related cases. Some detectives are directly employed by insurance companies and some are private detectives that are commissioned by insurance companies to investigate a particular case.
Insurance Detectives are called in to investigate a claim, suspect or not, especially when the amount involved is very substantial. For example, a wife of the insured filed a claim on her husband’s insurance policy and the sum involved is around $1,000,000. As an SOP, the insurance company will send an investigator to double check documents presented and confirm if any irregularity did occur or not.
The investigator would then double check all documents presented were in order. To double check the authenticity of the death certificate, the attending coroner would be the best person to ask. Then the identity of the beneficiary should be established next so the money will not be given to the wrong person. Background checking would usually cover employment records and credit records. When everything else that’s needed to be checked is checked, then it is time to submit a written report of all findings and recommendations. The final report should mean the work of the investigator is resolved, that is, if the file is clean and beyond doubt that an irregularity did not take place. However, if the investigator saw that an irregularity is afoot, as he would indicate in his recommendations, then the submission of the final report does not conclude the job. Once an irregularity or fraud has been established, the investigator would have to testify at court hearings how he had uncovered the attempted fraud.
To be an effective Insurance Investigator, of course, knowledge of the appropriate insurance laws and regulations is a must as well as legal procedures like court procedures. Background checking would entail interviewing all sorts of individuals so a bit of some psychology is needed. Great detectives would know how to assess a good character or not. In fraud cases, it is always the little details that give the schemer away. These little inconsistencies would ring alarms and give leads and so the detective should have sharp senses and be a critical thinker.
Those who want to live an exciting life of uncovering frauds and scams, the Insurance Investigator would be the perfect job. To be an Insurance Investigator, sign up for private detective course and then pass the licensure exams and then establish your reputation.