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How do I Become an Insurance Fraud Investigator?

By D. Jeffress
Updated May 16, 2024
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Tens of billions of dollars are lost each year due to people and businesses who purposefully deceive insurance companies. Insurance fraud investigators play a key role in catching people who submit false information about fires, automobile accidents, and workers' compensation, among many other schemes. To become an insurance fraud investigator, you must usually obtain a college degree and devote years to gaining experience and learning the trade at an insurance company.

Insurance fraud investigators need to be honest, detail-oriented, and quick thinking. Prospective investigators typically cannot have anything suspicious in their background or criminal record, and they must be willing to submit to extensive background checks. Many employers prefer to hire investigators with extensive experience in law enforcement and certain insurance jobs, such as claims adjustment and appraising. Employers often look for people who have a detailed understanding of both the legal system and the insurance business.

There are several educational paths that someone might take to become an insurance fraud investigator. Most often, future investigators receive bachelor's degrees in criminal justice, though some companies feel that an associate degree is sufficient for employment. In addition to traditional universities, colleges, and community colleges, there are many accredited online programs that offer both bachelor's and associate degrees in this field.

You'll usually be required to get licensed in a specific country or state in order to work as an insurance fraud investigator. Licensing procedures vary by location, though they usually involve the successful completion of a standard licensing exam. Although not a requirement, many hopeful investigators obtain certification from a respected organization, such as the International Association of Special Investigation Units, to help them stand out from the crowd. Investigators who wish to obtain certification usually pay a fee to take a certification exam.

As the number and severity of fraudulent insurance claims continues to rise, the need for skilled investigators is increasing. Competition for insurance investigator jobs can be fierce, however, because of the sheer number of qualified individuals in the job market. Even with a strong educational background, you may be need to take on a less significant role in an insurance company before advancing to the rank of investigator. You must demonstrate a strong knowledge of operations, organizational skills, and a willingness to succeed in order to become an insurance fraud investigator. With enough patience and experience, insurance investigators often go on to manage entire investigations departments or even open their own private firms.

SmartCapitalMind is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Discussion Comments
By Babalaas — On Jun 29, 2010

@ Georgesplane- Your advice about getting certification is good advice. Insurance fraud investigation is a competitive field. There are many qualified candidates for these jobs, so anything a candidate can do to gain an edge is important. Candidates with certificates offer employers reassurance that they are hiring candidates with high ethical standards.

Gaining a certificate is much more than simply passing a test. Being certified requires proper educational history, excellent references, and a rigorous testing process that covers many different areas of fraud examination. The examination covers:

1) Methods to prevent fraud.

2) What constitutes fraud.

3) What types of transactions are fraudulent.

4) Where to acquire data when investigating fraud.

Certified candidates are ready for the job with little or no training.

By Georgesplane — On Jun 29, 2010

Adding a CFE certificate can be a great way for an insurance fraud investigator to improve his or her credentials. The Association of Certified Fraud Examiners offers a rigorous testing process that awards successful candidates with a fraud examiners certificate.

The ACFE is an internationally recognized fraud detection organization, with chapters in many different countries. Another consideration is that fraud investigators with a CFE certificate make about 20% more than uncertified fraud investigators.

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