Insurance Claims Investigator: Job Description and Requirements

Apr 15, 2019

Insurance claims investigators review insurance claims, protecting the insurance company from paying out on invalid claims. Read the following information to find out more about the required training and skills, in addition to the job benefits, to see if it's the right spot for you.

Career Definition for an Insurance Claims Investigator

Insurance claims investigators plan and execute investigations into insurance claims related to bodily injury, liability, property damage, medical, worker's compensation and more. They protect insurance companies and policyholders against insurance fraud. Insurance claims investigators work irregular hours, both in an office and out in the field. Suspected cases of insurance fraud are referred to insurance claims investigators by insurance adjusters or examiners. Insurance claims investigators look into the background of claimants, witnesses and anyone else who has made a statement regarding the case, like medical professionals or police officers. They review the circumstances of the case through research, interviews, surveillance and in-person inspections of sites and vehicles, writing reports on their findings.

Required Education No formal requirements, bachelor's degree preferred
Necessary Skills Research, interviewing, communication, creativity, persistence
Median Salary (2018)* $65,900 (for all claims adjusters, examiners, and investigators)
Job Outlook (2016-2026)* 1% decline (for all claims adjusters, examiners, and investigators)

*Source: U.S. Bureau of Labor Statistics

Required Education

There are no formal educational requirements to become an insurance claims investigator, although most employers prefer candidates with a bachelor's degree. More important is related work experience, usually in law enforcement, law or insurance. Insurance claims investigators may choose to earn state licenses. On-the-job training is common, and insurance claims investigators participate in continuing education opportunities to keep up with new state and federal laws and legal precedents that may influence how insurance claims investigators do their jobs. Insurance claims investigators are knowledgeable about computers, research, surveillance, state and federal insurance laws and interrogation.

Required Skills

Insurance claims investigators excel at performing research and interviewing subjects. Their precise communication skills and quick thinking make it possible for them to interact with varied and dynamic personalities, obtaining information to support or deny a claimant's case. They must be creative and willing to do whatever it takes to close a case.

Career and Economic Outlook

The U.S. Bureau of Labor Statistics (BLS) expects a decline in jobs of 1% from 2016-2026 for the competitive field of insurance claims adjusters, examiners and investigators ( Insurance claims investigators had a median annual salary of $65,900, according to the BLS in 2018.

Alternate Career Options

Some skills necessary to become an insurance claims investigator will help prepare you for a career in other areas.

Construction and Building Inspector

High school graduates with background knowledge of construction trades can learn the additional required skills while on the job in this occupation, to check construction sites for code and ordinance compliance. Faster than average employment growth of 10% was forecast by the BLS from 2016-2026, and an annual median wage of $59,700 was reported in 2018.

Cost Estimator

Faster-than-average job growth of 11% was anticipated by the BLS from 2016-2026 for cost estimators. These professionals collect information to estimate the cost of resources necessary for constructing a building or manufacturing a product. Cost estimators usually earn a bachelor's degree in a field related to construction, although workers with extensive experience in construction may secure employment without the degree, according to the BLS. In 2018, cost estimators earned a median salary of $64,040 per year, the BLS said.

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