Auto Insurance Fraud Investigation

Auto insurance fraud costs insurers billions each year, which is passed on to the consumer in the form of higher monthly premiums. Because of these losses, auto insurers take claims fraud very seriously. In this article is a discussion of how an insurance fraud investigator may handle these fraudulent cases.

What’s Involved in a Fraudulent Claim?

Auto insurance fraud is defined as an omission or act that causes an insurer to compensate a policyholder for an exaggerated, nonexistent or unrelated injury. The most common types of fraud include fake injuries and staged collisions, arsons and thefts. A claimant can be guilty of fraud even if they don’t make a false representation; all they have to do is fail to disclose relevant information.

Different Types of Fraudulent Claims

There are two main types of auto insurance fraud: soft and hard.

These two types are explained in detail below.

  • “Soft” fraud cases are often seen as crimes of opportunity. A soft auto insurance fraud happens when a person inflates a claim by exaggerating the extent of an injury or loss.
  • “Hard” fraud cases are premeditated, and they occur when a person fabricates an auto insurance claim. These cases typically involve deliberate actions, such as a staged accident or theft.

The Fraud Investigation Process

A Las Vegas auto insurance fraud investigator may take several approaches in assessing a fraudulent claim. These methods may include:

  • Review of police reports. An investigator will analyze reports prepared by on-scene officers to determine if they contain inconsistencies and other suspicious items.
  • Review of witness statements. Insurance fraud investigators interview claimants and compare their statements to those made by other involved parties and witnesses.
  • Evaluation of medical reports. Investigators analyze physicians’ reports to determine the claimed injuries are medically proven.
  • Social media monitoring. These sites have become a must-see for insurance fraud investigators. In many cases, claimants brag about their schemes on sites like Twitter and Facebook, or they post videos and pictures of themselves taking part in activities that go against their claims of serious injury.
  • Database research. After the investigator gathers all the information they need, they will check it against information contained in insurance company databases. All insurers share information on policyholders’ accident and claims histories, and the fraud investigator compares the claim against past claims. Individuals with extensive claims histories may face a more detailed investigation.

Insurance fraud costs companies billions of dollars every year, but there are ways companies can reduce this expense. By hiring an auto insurance fraud investigator, a client can ensure the validity of policyholder claims and they can cut overall expenses.

About the Author

Jon Girard, CEO

At Elite Investigations, Inc. our mission is to provide professional investigative services that exceed our customer expectations. We achieve these goals through our commitment to attract and retain the finest investigators and personnel accompanied by our commitment to continuous improvement. We are completely committed to the principles of professionalism and integrity in the delivery of a complete range of effective and efficient investigation solutions.

Company Details

Elite Investigations
7435 S. Eastern Avenue
Las Vegas


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