Insurance Fraud Investigation

An insurance fraud investigation takes place when there is a suspicion of insurance fraud. These investigations may be conducted by an agent who works with the insurance company or an outside agency may be asked to conduct the investigation. During these investigations the insurance claim is researched. There needs to be a report of what occurred, how it occurred and who is the party responsible.

Insurance fraud is not only illegal it is costly for many. The immediate thought is that the insurance companies lose money when they pay out the fraudulent claims and not many people seem to sympathize with the large insurance companies. However these false claims also affect the insurance policy holders since the premiums are often raised in order for the insurance companies to cover these claims. Often there are false fires set to businesses or homes in order to collect on the insurance policy and this also causes the government money since the fire department must be called upon to deal with the fire.

An investigation may ensue if the claim is missing information or seems to be suspicious in any way. The insurance company may choose to alert the law enforcement agency and notify them that a person is currently under investigation for insurance fraud. These false claims may involve arson, falsified workers' disability claims, staged accidents, or unnecessary medical treatments.The private investigator may access a person's credit information and/or collect evidence by visiting the doctor's office if the claim is for medical benefits or visiting the scene of the accident or fire. If the claim is a workers comp claim the investigator may even choose to have the person under surveillance to make sure that the claimant is actually hurt and is not performing restricted activities.

Once the investigation has concluded if the insurance company determines that the claim is false they will not pay the claim and may involve law enforcement which would cause the claimant to face legal penalties. Anyone who is under investigation for insurance fraud should seek legal advice and quite possibly hire a lawyer regardless if they are guilty or innocent.


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