Insurance Investigators Job Description

March 20, 20120 Comments

Insurance Investigators Job Profile and Description

Insurance investigators examine and review insurance claims, thereby protecting the insurance company from paying out on claims that may be invalid or illegally claimed. They have to plan and execute these investigations into insurance claims made by the customer related to accidents, illness, liability, property or vehicle damage, worker’s compensation and so on.

Duties and Responsibilities

  • The primary responsibility of insurance investigators is to keep the insurance companies and policy holders from being victims of insurance fraud
  • When an insurance company suspects fraud in a case, the insurance adjusters or examiners refer the cases to insurance investigators
  • Insurance investigators also need to investigate the background of claimants, various records, risks involved, witnesses who made statements regarding the case, like doctors or police officers, agents etc
  • They conduct extensive research, interviews and even surveillance, besides personal inspection, to review the circumstances of the case
  • Based on their findings, they need to write reports and submit them along with their recommendations
  • They need to be aware of the various rules and regulations and legal procedures
  • They also make calculations on the benefit payments and approve payment of claims within a certain monetary limit

Skills and Specifications

  • Insurance investigators must know about computers, research, surveillance and interrogation
  • They must have excellent communication skills and an eye for details
  • They must be analytical and be able to deduce conclusions from matter
  • Quick thinking and presence of mind is also needed
  • They often have to work irregular hours, both in the office and out in the field, so they need to able to deal with stress and work under pressure

Education and Qualifications

Insurance investigators have a bachelor’s degree preferably in the field of finance, insurance, sales, law and law enforcement. However, much of the work is learnt on the job.

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