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Insurance Claims Investigations

According to a worldwide study, real estate fraud between 2011 and 2015 reached $34 billion per year. Fraud in healthcare services alone amounted to $260 billion in 2010. For this reason, it has been inevitable to conduct a study on Insurance Claims Investigations.

False insurance claims created by humans have reached almost all-time highs. Insurance fraud can come in all forms, from fraudulent claims to misinformation in a document, and even faking an injury.

This is where insurance detectives specializing in Insurance Fraud Investigations step in to investigate these fraudulent activities.

Our insurance detectives, who work in Zabata Private Detective Services, have the qualifications to provide perfect service to detect all the potential insurance frauds, thanks to the knowledge gained by more than 25 years of experience.

What Do Insurance Detectives Do?

An insurance fraud detective will review the relevant insurance claim on behalf of your firm to determine if fraud has occurred in any event. He can inspect damaged property, work coordination with law enforcement, meet with the plaintiff and gather information about the occurred damage.

Although insurance fraud is a crime, insurance detectives who work to detect insurance fraud do not make any arrests. Thanks to the report prepared by Insurance detectives, it helps law enforcement officers do their job.

Insurance Claims Investigations

So what kind of path do insurance detectives follow during Insurance Claims Investigations?

Reviewing Past Insurance Claims

Our insurance detectives examine the past claims of the relevant person or institution and check whether there is anything that indicates fraud. It examines how often insurance claims are made and the content of the claims. It will also look for identifying patterns to see if certain people are more likely to commit insurance fraud than others. They examine the models of all customers with specially prepared data analysis methods. In this way, they immediately detect signs of insurance fraud.

Examining Suspicious Signals for Insurance Claims Investigations

When our insurance detectives conduct fraud investigations and look at customer claims, they pay attention to things like these to be certain of nothing suspicious about the declaration.

  • Repair expenses documented by handwritten receipts submitted in a claim for a damaged
  • An increase in home or automobile insurance premiums before the insurance claim
  • Whether there is a material financial issue on behalf of the person making the insurance claim
  • Lack of police reports on the alleged accident

While these signs don’t always prove insurance fraud, they encourage insurance detectives to dig deeper into the matter.

Use of Technology

Thanks to the software we use, false invoices and fees can be easily detected.

This software use data and trends to investigate the legitimacy of requests. Seeks multiple surgeries in one claim for the same body part for health-related claims. They can then detect every possible fraud in any insurance claim, including auto insurance.

Social Media Review

Not all insurance claims are subject to a social media review. However, if the situation is suspicious, a social media review is done to learn more. They research to check if the person making the insurance claim is actually injured or if their home is damaged. Social media often provides more information than you can find elsewhere.

Statistics show that insurance fraud is becoming more common in all insurance industries. Insurance fraud may cover many areas including home, car to life insurance.

If you would like to examine insurance claims on behalf of your company, please do not hesitate to call us to benefit from our Insurance Fraud Investigation service, which we offer with our Zabata Private Detective Bureau insurance detectives, which consists of our expert staff.