The job of an insurance investigator is to make sure that all insurance claims submitted are valid and relevant. Some insurance investigations are done as part of routine audits, just to make sure fraudulent practices are not widespread. At other times, the investigator is after a specific target, whom the company may have reason to believe has not submitted a justifiable claim. Tens of thousands of individuals are employed as investigators.
Insurance investigators may be private investigators or employees of the insurance company. Those employed by an insurance company often have the security that comes with a full-time job, which includes a guaranteed salary plus benefits. This situation offers the most stability. A private investigator is not a full-time employee, but rather a contracted agent who works for an insurance company on a case-by-case basis. An insurance investigator in private practice may also investigate other types of situations, as time and business permit.
Often, an insurance investigator is called upon to investigate claims of disability. Some disabilities may not be detectable by medical science. Others may be misstated by the claimant to be worse than they really are. People often try to capitalize on that ambiguity by falsely claiming they have a disability. In such cases, the investigator will secretly observe the individual, and try to determine if the problem is as debilitating as claimed.
Another situation that an insurance investigator may pursue is a case of auto insurance fraud. The most common type of auto insurance fraud relates to false reports of stolen vehicles. An experienced investigator should be able to follow a paper trail, through public records, and determine whether the car really was stolen, or whether the owner may have sold the car and then reported it as stolen. If there is a fraudulent claim, the insurance company can deny payment if it has not been made, or pursue civil or criminal remedies. In such cases, the insurance investigator will likely be called to provide evidence and testimony in court.
Though fraud investigations represent an important part of what an insurance investigator does, there are other job duties that may be assigned. For example, some investigators may specifically focus on automobile collisions, trying to determine fault, and getting the responsible party to pay for damages. Though oftentimes the insurance company will simply accept an accident report filed by local law enforcement, there may be times when it will conduct its own investigation, especially if there is reason to doubt a report offered by law enforcement, or if law enforcement was not present at the scene.
