How Do I Become an Insurance Claims Investigator?

Insurance fraud costs policyholders millions of dollars every year. In an effort to combat insurance fraud, many insurance companies employ claims investigators. The requirements to become an insurance claims investigator may vary by jurisdiction, as well as by company within a jurisdiction. In general, the qualifications needed to become an insurance claims investigator include at least a high school diploma, work experience in law enforcement or the insurance industry, and exceptional technology skills. A college degree as well as a state license may also be needed to become an insurance claims investigator.

Insurance companies are always at risk of losing money due to fraudulently filed claims. In some cases, a policyholder files a claim for a loss that never happened, while, in other cases, a victim alleges injuries that either never happened or are far less severe than he or she is claiming. Insurance fraud may be considered a crime in many jurisdictions; however, law enforcement often lacks the resources to pursue charges related to insurance fraud. As a result, insurance companies must frequently investigate suspicious claims on their own. A claims investigator may interview witnesses, research the background of a claimant, engage in surveillance, or personally inspect alleged damage in an effort to determine whether a claim is legitimate.

Many insurance companies do not require an applicant to have a bachelor's degree in order to become an insurance claims investigator. A college degree, however, is certainly helpful. An educational background in business, informational technology, or criminal justice is recommended even if not required. Any training in information technologies is a benefit to an applicant as much of the investigation process is accomplished by using technology.

Prior work experience is generally the most important factor needed by anyone who plans to become an insurance claims investigator. Most insurance companies look for someone with previous experience in law enforcement or in the insurance industry itself. A thorough knowledge of the insurance industry is needed as well as investigation skills. Many insurance companies will provide in-house training to successful applicants regarding the specific issues an investigator will face when investigating an insurance claim. An applicant is typically, however, expected to have basic investigation skills when applying.

As with the educational requirements, a private investigator license may not be required but is often recommended. Within the United States, most states offer the option to become licensed as a private investigator. Having a license may help an individual's chances significantly of obtaining employment as an insurance claims investigator. In addition, having a private investigator license will allow an investigator to use additional methods and techniques when working on a case.