An insurance fraud investigator is an individual who works for an insurance company in order to determine if a claim is made under false pretenses. This is especially true of disability claims, where individuals may say their movement or quality of life is limited because of chronic pain. Due to the fact that chronic pain is often hard to prove medically, this can present a problem for insurance companies. Some also may investigate medical bills, but these are easier to verify.
In some cases, a fraud investigator will work for an insurance company on a full-time basis. The larger companies often have enough cases where they can support an individual, or even an entire department, in this capacity. The other alternative, of course, is to use the services of a private investigator, contracting for services only when needed. This is the way many investigators in private practice make their living.
After an insurance fraud investigator is given a case, he or she will usually start gathering somebackground information. The case file will include the subject's last known address and any other personal contact information available. The complaint filed will also be on hand so that the investigator can determine if the complaint is valid. For example, in a disability case, the person involved may claim they do not have the use of his or her legs.