Insurance investigators can earn the Certified Insurance Fraud Investigator (CIFI) certification through the International Association of Special Investigation Units. To qualify, you must have a bachelor’s degree and a minimum of three years of experience in insurance fraud.
How to Become an Insurance Fraud Investigator : Insurance Careers
What does an insurance investigator do?
To determine the validity of suspicious insurance claims, insurance investigators examine the claims. Suspected claims under investigation include staged accidents, unnecessary medical treatments, and arson.
The process is started by gathering and reviewing relevant documents by the insurance investigator. They then interview the victim and witnesses for a statement. Insurance investigators may also observe the claimant through surveillance and social media tracking to see if they do anything that would suggest that they do not have an injury in order to determine whether the injury reported is legitimate. Other common tasks for insurance investigators include:
The insurance investigator writes a report of their findings after the investigation is finished and sends it to attorneys. Depending on the circumstances, the insurance investigator might be asked to give a courtroom testimony regarding their findings. A private consulting firm, business, or government agency may hire insurance investigators. They often work in the following types of insurance agencies:
What is an insurance investigator?
An insurance investigator examines and investigates an insurance claim to make sure there isn’t any fraud going on. To better understand the situation and determine whether the claim is legitimate, they assemble data from the insurance adjuster, law enforcement, the claimant, and witnesses.
Average salary of an insurance investigator
To fully understand insurance laws and regulations, insurance investigators must complete varying amounts of education, licenses, and certifications. The steps to becoming an insurance investigator are as follows:
1. Complete high school education
For insurance companies, the typical requirement for insurance investigator positions is a high school diploma or GED. Although not required, it is advised that you take speech classes and join the debate team to help you get better at interviews. You can better prepare yourself to write insurance claim reports by taking English classes.
2. Earn a degree
A degree in criminal justice may be beneficial for you since many insurance investigator jobs either require or prefer a bachelor’s degree. Additionally, you could study for a degree relevant to the kind of insurance company you want to work for. For instance, if you want to work with factory insurance claims, you could pursue an engineering degree, or if you want to work with business fraud, you could pursue an accounting degree.
3. Get licensed
Licensing requirements for insurance investigators vary by state. Many only require you to pass an ethics test, while others involve timed exams covering pertinent laws and regulations for their state government. Insurance investigators can work without a license in some states. However, you are more likely to need a license if you want to work for insurance companies as a private investigator.
4. Become certified
Insurance investigators are not required to have certifications, but obtaining one demonstrates your dedication to the industry and may open up more career advancement opportunities. Through the International Association of Special Investigation Units, insurance investigators can become Certified Insurance Fraud Investigators (CIFI).
You need a bachelor’s degree and at least three years of experience in insurance fraud to be eligible. Without a bachelor’s degree, applicants must have at least 10 years of insurance industry experience. You must pass an exam that covers software usage, organized fraud case study, insurance fraud terminology, and medical fraud case study in order to receive your CIFI certification.
The Association of Certified Fraud Examiners offers the Certified Fraud Examiner (CFE) designation to insurance investigators as well. You must pass an exam that covers financial transactions and fraud schemes, law related to conducting fraud examinations, fraud prevention and deterrence, and investigations related to interviewing and gathering information in order to earn this credential.
5. Develop related experience
Before applying for a position as an insurance investigator, it may be beneficial to work in the insurance industry. However, prior employment in the field of law enforcement is advantageous as well because it can help you develop your interviewing abilities, learn about insurance laws, and learn how to properly document evidence.
Those with relevant work experience typically receive preference in the hiring process. New insurance investigators typically receive on-the-job training, beginning with simple cases under the direction of experienced investigators before working on more difficult cases.
Frequently asked questions about being an insurance investigator
You may have the following common inquiries as you consider working as an insurance investigator:
What skills are needed to become an insurance investigator?
Someone with in-depth knowledge of insurance law makes a successful insurance investigator. Because insurance investigators conduct numerous interviews, it’s crucial to have excellent communication and active listening skills. Other skills you may need include:
Whats the difference between insurance investigators and underwriters?
The stage of the insurance process at which they perform their work is the primary distinction between an insurance investigator and an underwriter. An insurance underwriter determines the initial risk and cost of the policy before the claim is approved, and an insurance investigator assists an insurance company in deciding whether to pay for a claim. Underwriters rely more on data from particular software when making decisions, while insurance investigators obtain the majority of their data from interviews and other forms of secondary research.
When do insurance investigators work?
Insurance investigators frequently put in erratic hours to fit client meetings in. Since they deal with individuals who are employed during regular business hours, their work schedules may include evenings and weekends.
What is the work environment of insurance investigators like?
Insurance investigators mostly work in company offices for research. However, they might also work outside when inspecting damaged property. When examining vehicle damage, investigators must spend a significant amount of time at auto body shops to determine the cost of repairs, whereas when examining building damage, they may be near potentially dangerous areas with collapsed roofs and weak structures.
What do insurance investigators do?
When an insurance provider suspects fraud or criminal activity, such as arson, staged accidents, or unnecessary medical treatments, the investigation is handled by insurance investigators. Cases of insurance fraud can range in severity from exaggerated claims of vehicle damage to intricate fraud rings.
What are insurance investigators called?
Most private investigators obtain the majority of their work from insurance companies by looking into their alleged fraudulent claims. Consequently, a PI may also be known as an Insurance Investigator or a Fraud Investigator.
Are insurance investigators Real?
Investigators in this field have differing specialties and backgrounds. While some insurance companies employ their own internal investigation teams, other businesses outsource the work to private investigators or private investigation firms.
How do I become a SIU investigator?
To be eligible for SIU investigator training and to become certified as an insurance fraud investigator, you must have at least a bachelor’s degree and relevant work experience. You must also accept a code of ethics and do well on a test.