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Insurance Investigator: Job Description and Education Requirements

Sep 15, 2019

Learn about the education and preparation needed to become an insurance investigator. Get a quick view of the requirements as well as details about training, job duties and certification to find out if this is the career for you.

Insurance investigators are required to have a high school diploma, and they may be required to be licensed or certified. A background in law enforcement, insurance claims, or firefighting may be an asset to those pursuing a career as an insurance investigator. Professionals in this field conduct investigations to uncover fraudulent activity regarding insurance claims.

Essential Information

Insurance investigators are claims workers, some with a background in criminal justice, who delve into claims cases to uncover possible criminal or fraudulent activity. Like detectives, insurance investigators may comb through stacks of paperwork, conduct interviews or perform surveillance. Prospective employers value previous experience in insurance claims or police work as well as a college education.

Required Education High school diploma
Other Requirements Previous law enforcement or insurance experience; licensure and a background check are required by most states
Projected Job Growth (2018-2028)* -4% increase (claims adjusters, appraisers, examiners and investigators)
Median Salary (2018)* $65,670 (claims adjusters, examiners and investigators)

Source: *U.S. Bureau of Labor Statistics

Insurance Investigator Job Description

The specific nature of an insurance investigator's work varies based on professional experience and education. Some insurance investigators handle simple fraud cases involving improperly filed paperwork or false identities. More experienced investigators will handle instances of fraud by means of arson or theft. Insurance investigators spend a substantial amount of time gathering and analyzing forensic evidence from accidents or crime scenes.

Responsibilities

Insurance companies employ investigators to screen claims for a wide range of offenses, like the over-reporting of damage to insured property or the staging of automobile accidents. Occasionally, investigators are used to investigate a company's own employees for misconduct or illegal activity. Some insurance investigators specialize in the medical field and concentrate on a specific type of fraud, such as unneeded treatments or stolen medical equipment.

An insurance investigator spends a significant amount of time gathering evidence. This process can be tedious and time consuming, involving tactics such as crime scene photography and gathering witness statements. Some cases might require surveillance of suspects or suspicious activity.

Education Requirements

Experience as a law enforcement or criminal justice professional is vital to securing employment as an insurance investigator. Insurance companies tend to hire candidates who have worked as police officers or forensic laboratory technicians. Employment as a firefighter can also lead to a job as an insurance investigator. The U.S. Bureau of Labor Statistics (BLS) says there are no minimum education requirements to become an insurance investigator, though a high school diploma is typically considered a necessity.

Certification Information

Most local jurisdictions require private investigators to maintain a license, but requirements vary. Some states have no system whatsoever and others simply require investigators pay a fee and take an ethics exam. Other states have strict regulations involving investigators. California, for example, demands that aspiring investigators possess criminal justice education or law enforcement experience. In most states, candidates have to pass a background check; a felony conviction can disqualify individuals seeking a career as an insurance investigator.

Job Outlook and Salary Information

In 2018, BLS figures showed that approximately 328,500 individuals were working as claims investigators, adjusters or examiners. Employment in this field is projected to decline at a rate of four percent between 2018 and 2028, according to the BLS. Data from the BLS shows that claims investigators, adjusters and examiners earned a median salary of $65,900 in 2018.

Insurance investigators assess claims to identify instances of criminal activity or insurance fraud. Their job may involve reviewing paperwork, interviewing witnesses and reviewing surveillance footage. In most states, insurance investigators must pass a background check and may need to be licensed or certified.

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