What is an Insurance Fraud Investigation?

Fraud is considered misrepresentation with the intent to deceive in order to reap financial gain. This practice is immoral, unethical and downright dangerous, so if you suspect someone is committing these crimes you should enlist the help of a quality insurance fraud investigator.

When You Should Call an Insurance Fraud Investigator

The initial signs of insurance fraud include any suspicious behaviour that will eventually lead to insurance companies paying out a lump sum of money for a reason that is difficult to prove. The most common form of insurance fraud is the exaggeration of injuries. If the individual claims they could not work as a result of said injury then the claimed symptoms must be examined and recorded by a medical professional.

Other cases involve people bending the truth of situations, like claiming an accident happened for which they need to be compensated because they sustained an injury, when in fact the injury is the result of another event. So, for example, an individual claims to have hurt their back in a car accident in hopes of claiming from the Road Accident Fund when in fact they slipped in the shower or some other situation that wasn’t in a car at all. Almost half of all fraud cases are uncovered by whistle blowers, so if you suspect foul play, don’t keep it to yourself.

What is an Insurance Fraud Investigation?

There are two kinds of insurance fraud: hard insurance fraud and soft insurance fraud. Hard insurance fraud is when a claim is completely fabricated.Soft insurance fraud is inflating the value of an otherwise legitimate claim. The majority of an insurance fraud investigator’s time is dedicated to dealing with soft insurance fraud cases.

Insurance fraud investigations are not just for insurance companies though, because they often involve other people. People often make claims against the estate of others they have implicated in the accident.

How an Insurance Fraud Investigator Can Help

If you have a suspicion or any evidence that an individual is implicating you in fraudulent activity or that they are outright lying about a medical condition or other claim you should report it. It is your ethical responsibility to ensure that insurance is dealt with fairly so that the system cannot be cheated because of somebody’s skewed moral compass.

If you require the help of a professional insurance fraud investigator contact us and we will get to the bottom of it in no time.

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