Insurance Fraud Investigator

Job Summary

Responsible for handling claims where fraud is suspected. Performs surveillance, investigates claims, interviews witnesses and suspects, takes photographs, and provides final recommendation.

Primary Responsibilities

  • Handle claims where fraud is suspected.
  • Investigate cases of arson, where fires may have been set intentionally to cash in insurance claims.
  • Examine falsified workers' disability claims.
  • Set up surveillance and attempt to catch people suspected of fraud in the act.
  • Investigate possibly staged accidents.
  • Determine if medical treatments were necessary.
  • Examine vehicular damage.
  • Verify claimant's identity.
  • Visit claimants and witnesses to obtain an oral statement.
  • Take photographs and document evidence.
  • Examine videotapes to detect fraud.
  • Inspect facilities.
  • Determine if doctors have a proper license.
  • Consult with legal counsel.
  • Testify as an expert witness in court case.
  • Inspect damaged buildings and automobiles.
  • Investigate doctors suspected of malpractice.
  • Create detailed reports documenting incidents.
  • Perform background checks.
  • Examine medical reports.