Private investigators have a cultural reputation for many things—surveillance, infidelity, undercover operations—the exciting things we’re used to seeing in movies and television. Many people are unaware that private investigators also take a huge piece of their corporate pie from insurance investigation. Private investigators use their unique skillsets and experiences to pursue the truth in insurance claims to establish their merit and prevent insurance fraud.
There are many ways to commit insurance fraud. For example, a homeowner might remove property from their home and then report it as stolen. They might deliberately cause damage to their property and then report a freak occurrence, or weather, as the culprit. When a suspect claim comes across a processor’s desk, they can hand it over to a private investigator to perform due-diligence and vet the claim.
Private investigators can use their famed surveillance methodology to track the homeowner to a secure location where “stolen” property is being stored. They could use their access to verified databases to look at an individual’s various histories, such as criminal, transience, and litigation. All relevant information is compiled and generated in the form of a comprehensive report in which the private investigator provides clear recommendations regarding the validity of the claim.
Sometimes insurance companies only want the private investigator to take pictures of an accident site, or an injury, or maybe they just want some spot-check surveillance on an employee claiming worker’s compensation. Another way insurance companies can rely on private investigators is with document review. Private investigators can comb repair receipts, financial records, police reports, and social media for evidence the claim is fraudulent.
Some insurance companies rely on their own internal investigators to vet and process their claims. It may be more cost-effective to keep the investigation in-house, or leadership might be more comfortable using an internal investigator. The inherent problem with any internal investigation is that any investigating agents who have a stake—direct or otherwise—in the insurance company cannot be completely objective. In an industry where litigation is not only possible, but likely, insurers and guarantors of benefits must be sure their investigations are comprehensive and will hold up to scrutiny.
A common unforeseen issue with handling insurance claim investigations internally is that it has the potential to slow down daily operations. Claims gather and bottle-neck at the choke point in the process, causing employees to feel overwhelmed and increasing their margin of error, which may result in more lost time and resources correcting those errors. One of the greatest advantages of hiring a private investigator to vet insurance claims is their valuable autonomy. They have their own databases, their own league of investigators, and their own processes. The investigations process can move quickly because there is very rarely a chain of command and little bureaucracy involved, leading to more closed claims and greater success for the company.
Contracting due-diligence out to private investigators means less stress on internal employees and another layer of credibility for the investigation. Whether as a replacement for an internal team or on a case-by-case basis, private investigators can give insurance providers the valuable information and expertise they need to close cases swiftly and effectively.