Insurance Fraud Investigation – The Role Of Private Investigators

Insurance Fraud Investigation

Insurance frauds are a terrible malaise of the insurance industry with no cure. The best way for insurance companies to guard against fraudulent claims that cost the industry billions of dollars annually is to investigate suspicious claims in-depth. 

Since the insurance companies do not have the resources to carry out such investigations, in most cases, they entrust the jobs to some private investigation companies like Discreet Investigations, which have a proven track record. Private investigators handle many insurance fraud cases, which are serious crimes and can take different forms. Familiarity with the methods used by criminals to cheat insurance companies is essential for private investigators to understand the types of insurance fraud. Solid evidence provided by private investigators helps insurance companies take legal action against fraudsters and prevent losses. 

Types of insurance fraud

Staged accidents, exaggerated claims, arson, and phantom claims are the most common types of insurance fraud. 

  • Staged accidents –Personal injury laws allow accident victims to claim compensation for injuries and damages. Bad actors are always ready to cheat insurance companies by staging accidents and posing as victims. They file fictitious claims of high amounts. The cheaters plan well to stage accidents in many ways, such as slip and fall incidents, vehicle collisions, and other accidental injuries that help them create false narratives and file compensation claims.
  • Inflated claims – Inflated or exaggerated claims differ from staged accidents because such claims are legitimate. Still, the extent of injuries and damages are inflated to claim higher compensation from the insurance company.
  • Phantom claims – Also known as ghost claims, Phantom claims are false claims lodged by fraudulent parties for incidents that never occurred. The most common example of such a claim is when an individual claims something is lost or stolen when no such incident happened. 
  • Arson – To claim compensation, the property owner who holds an insurance policy intentionally fires the property to facilitate filing a claim for damages. 

Insurance fraud investigation 

The primary goal of any private investigator investigating insurance fraud is to conduct investigations to ascertain if the incident happened and whether there has been any occurrence of fraud. The investigation process might involve interviewing witnesses, gathering physical evidence, and reviewing police reports.

Besides the initial investigation, a Personal investigator may conduct surveillance if there is any need to gather further evidence. Surveillance involves monitoring the activities of the suspected party to determine if the actions taken by them were consistent with the reported damages and injuries.

Private Investigators must thoroughly understand the laws related to insurance fraud. Since insurance fraud can amount to a criminal offense, investigators must be familiar with the laws that help them build a strong case based on effective investigation supported by strong physical and other evidence.  

Private investigators play a crucial role in protecting insurance companies from fraudulent claims, helping keep insurance costs low, and consumers are the ultimate beneficiaries. With multiple investigating companies, you must work with the right service provider. Check out multiple ones before you finalize one. 

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