Insurance Careers--Fraud Prevention

For those that have a criminal justice background but realized law enforcement might not be for them, a career in insurance fraud prevention and investigation may be an ideal job.


The draw of the job is using those crime-fighting skills to research and verify that claims are legit.  For example, you may need to make sure that an injured worker making a work comp claim is in fact injured through investigative measures or doing the legwork to make sure that stolen car claim was actual. Insured fraud costs consumers billions of dollars every year across all lines of business.

The Facts

About 57 percent of insurers predict an uptick in personal-property fraud by policyholders. Almost 58 percent say the same for personal auto insurance, and 69 percent anticipate a rise in workers-compensation scams, meaning there is no shortage of job opportunity for this branch of insurance. A staggering 61 percent anticipate an increase in auto-insurance fraud by organized rings, and 55 percent foresee a jump in workers-compensation scamming.


If you have a knack for interviewing or just like getting to the "bottom" of things this career path provides ultimate job satisfaction.

Qualifications for Insurance Fraud Professionals

While licensing requirements for these types of professionals varies by the state, some require you to hold a specific certificate or license to be an insurance fraud specialist. If you don't have a criminal justice background, an insurance background is helpful.  If you are crossing over from law enforcement, you will want to look into obtaining an insurance license through your home state. Or at the very least take a pre-licensing course to familiarize yourself with the industry. Keep in mind some states may actually require you to take a licensing class. You can find out more through your state‚Äôs insurance regulatory department. And of course, most states will require a background check.


While preferential treatment may be given to those with a background in law enforcement or a claims background, don't let that discourage you. Insurance companies do offer on-the-job training to the right individuals. You would start out working on simple cases alongside an experienced investigator before moving on to more difficult assignments.


Fraud Investigator Duties

Through their investigative work, fraud investigators examine government and insurance databases to discover background information on claimants, witnesses, and potential accomplices. After accumulating electronic information, fraud investigators may visit and interview claimants. If considered necessary, they may also conduct surveillance work, going undercover to gather information not otherwise accessible from databases and interviews.

Fraud investigators will often serve as witnesses in legal cases that result from insurance and government fund-appropriation disputes. It's imperative that they be legal experts in their rights because an understanding of laws that pertain to public and insurance funds is essential for their work. Furthermore, because they may also perform surveillance work, fraud investigators must also be mindful of the legal limits of private investigation.


Depending on your experience, location and education level, you could expect to make anywhere from $38,000 to $75,000 annually.

This is part 6 of a multi-post series.  Please visit the other Insurance Career posts below:


Insurance Careers--Sales

Insurance Careers--Training

Insurance Careers--Compliance

Insurance Careers--Management

Insurance Careers--Underwriting

Insurance Careers--Fraud Prevention...Now Playing!

Insurance Careers--Claims





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