Steps To Becoming An Insurance Investigator: A Guide

Insurance fraud investigators play a crucial role in ensuring insurance companies handle claims fairly and honestly. They are responsible for investigating allegations of fraudulent behaviour by claimants or employees of an insurance company, including identity theft, hacking, employee-agent fraud, and claims insurance fraud. To become an insurance fraud investigator, you typically need a high school diploma, a degree preferably in criminal justice, and specific work experience in the insurance industry. In this paragraph, we will explore the steps and requirements to become an insurance fraud investigator, including education, work experience, and relevant skills.

Get a bachelor's degree in criminal justice, finance, or business

A bachelor's degree in criminal justice, finance, or business is a great starting point for a career as an insurance investigator. This is a versatile and exciting career path that is in high demand due to the prevalence of insurance fraud. Insurance fraud is a widespread issue, costing companies over $40 billion annually and leading to higher premiums for honest policyholders.

A bachelor's degree in criminal justice provides a solid foundation for this career. Coursework in criminal justice programs covers legal aspects, research, investigation techniques, and critical thinking skills. These skills are essential for insurance investigators, who need to understand the legal framework within which they operate and conduct effective, well-informed investigations.

Alternatively, a degree in finance or business can also be advantageous. Insurance investigators often deal with financial claims and fraud, so a strong understanding of finance and business principles can be beneficial. Courses in financial risk management, insurance types, and claims investigations are particularly relevant and can provide valuable knowledge for aspiring insurance investigators.

While a bachelor's degree is not always mandatory, it is preferred by many employers. Obtaining a degree in these fields demonstrates a strong academic foundation and can open more professional opportunities. It is worth noting that some states may have specific licensing requirements for insurance investigators, so be sure to check the regulations in your state.

In addition to a bachelor's degree, gaining relevant work experience is crucial. Insurance companies often favour candidates with prior experience in law enforcement, private investigations, or insurance claims adjusting. This experience allows individuals to develop the necessary interviewing, research, and analytical skills required for insurance investigations.

Pursuing a bachelor's degree in criminal justice, finance, or business is an excellent step towards becoming an insurance investigator. It provides a strong academic base and can lead to further professional development and specialised certifications in this exciting and challenging field.

Gain relevant work experience

Gaining relevant work experience is crucial if you want to become an insurance investigator. While a high school diploma is the minimum educational requirement for entry-level positions, employers often prefer candidates with a bachelor's degree in a relevant field such as criminal justice, finance, or business.

The best way to gain relevant work experience is to seek out opportunities that will allow you to develop the skills necessary for a career in insurance investigation. This could include working as a police officer, private investigator, insurance claims adjuster, or firefighter. These roles will help you hone your interviewing, research, and investigative skills, which are essential for detecting insurance fraud.

On-the-job training is also common in this field. New insurance investigators often start by working on simple cases under the supervision of a more experienced investigator before progressing to more complex assignments. This is a great way to learn the ropes and develop the skills needed to excel in this career.

In addition to investigative and research skills, insurance investigators need strong technical skills to understand software applications used to review claims and interpersonal skills to conduct interviews and liaise with other professionals. Creativity, persistence, and analytical skills are also highly valued, as they enable investigators to think outside the box, follow leads doggedly, and spot discrepancies in the information they gather.

Remember, the more experience you have in investigating potential crimes and understanding the insurance industry, the more attractive your profile will be to potential employers. So, focus on gaining diverse and relevant work experience to set yourself up for success in this exciting and challenging career.

Obtain a driver's license

A valid driver's license is essential for insurance investigators, as they often work outside the office and need to travel to examine claim sites in person. A clean driving record is also important. Some companies may also require the use of a company-approved vehicle, which must be reliable and nondescript. This is particularly important for investigators as they often need to conduct covert surveillance.

In addition to a driver's license, some insurance investigator roles may require a certain level of physical fitness, as there may be a need to work outside standard business hours and travel at short notice. This could include overnight travel and working on weekends or holidays.

Therefore, a valid driver's license, a reliable vehicle, and a clean driving record are key requirements for insurance investigators, enabling them to effectively carry out their duties and handle the unpredictable nature of the job.

Get licensed in your state

Licensing requirements for investigators vary from state to state. While some states require employees who do investigative work for insurance companies to obtain a license, others do not. In some states, the only requirements for a license are passing an ethics test and paying a fee. However, other states may require completion of an educational program or an examination on insurance investigating. Some states also require continuing education.

Most states require insurance investigators to be licensed as private investigators, which involves a specific set of education and experience requirements, as well as a written test in some cases.

It's important to check the specific licensing requirements for your state, as they can vary significantly.

Develop technical, research, analytical, and interpersonal skills

To become an insurance investigator, you'll need to develop a range of technical, research, analytical, and interpersonal skills.

Technical skills are important because investigators need to understand and navigate software applications used to review and flag claims. A working knowledge of relevant legislation is also crucial.

Research skills are fundamental to the role of an insurance investigator. You'll need to be able to access public records, databases, and even social media to gather information about claims and claimants.

Analytical skills are essential for connecting the dots and spotting discrepancies in the information you gather. Over time, these skills will help you apply knowledge from previous cases to new ones.

Interpersonal skills are vital for interviewing people over the phone and in person. You'll also need to liaise with other professionals, such as private investigators and law enforcement, to assist with confirming or providing information.

In addition to these core skills, persistence, creativity, and conflict management abilities will also benefit your career as an insurance investigator.

Frequently asked questions