insurance fraud investigation

Insurance fraud investigation involves examining claims to detect dishonest activity intended to deceive the insurer for financial gain. Investigators review documents, interview claimants and witnesses, analyze financial and medical records, and sometimes conduct surveillance to identify inconsistencies or suspicious behaviors. Their goal is to ensure claims are legitimate, prevent dishonest claims from being paid, and protect honest policyholders. The process combines thorough analysis, evidence collection, and adherence to legal and ethical standards to differentiate between genuine claims and fraudulent activities effectively.