How to Become an Insurance Claim Investigator

How To Become an Insurance Claim Investigator. Insurance companies frequently conduct claims investigations to determine the validity of a claim. Insurance investigators contribute to the fairness of insurance claims. When a company suspects a claim is fraudulent, it turns to insurance investigators for assistance.

How To Become an Insurance Claim Investigator

As an insurance investigator, you can use your critical thinking skills to assist insurance companies in making sound decisions. The investigation process aids the claims adjuster in making a decision on how to handle a claim.

There are several steps involved in becoming an insurance claim investigator. If you desire to know how to become an insurance claim investigator this article will give you detailed information.

How To Become an Insurance Claim Investigator

Individuals interested in working as insurance investigators should pursue a bachelor’s degree in criminal justice or a related program. Many investigator jobs only require a high school diploma. However, many hiring managers prefer candidates with relevant work experience or education.

Also, some investigators are required to be licensed. Industry knowledge is also important, people with degrees in business administration, finance, or risk management may have more opportunities.

To fully understand insurance laws and regulations, insurance investigators must complete a variety of education, licenses, and certifications. Here are the steps on how to become an insurance claim investigator.

Obtain A High School Diploma

To work for insurance companies, insurance investigators typically need a high school diploma or GED. While not required, taking speech classes and joining the debate team can help you improve your interviewing skills. English classes can also help you prepare to write insurance claim reports.

Get A Degree

Many insurance investigator jobs require or prefer a bachelor’s degree, so a degree in criminal justice may be beneficial. However, insurance companies prefer to hire investigators with college coursework or degrees.

In addition, the degree required varies according to the type of claims work. For example, if you want to work with factory insurance claims, you could pursue an engineering degree. An accounting degree might be necessary if you want to work with business fraud.

Obtain a License

State licensing requirements for investigators differ. In some states, an investigator working for an insurance company is not required to have a license. In some states, passing an ethics test and paying a fee are the only requirements for obtaining a license.

Other states require the completion of a training program or examination in insurance investigation. Insurance investigators are not required to have a license in some states. In some states, continuing education is also required.  However, if you want to work as a private investigator for insurance companies, you will almost certainly need a license.

Obtain Certification

Insurance investigators are not required to have certifications, but having one shows your dedication to the field. This may lead to more opportunities for advancement. The International Association of Special Investigation Units offers the Certified Insurance Fraud Investigator (CIFI) certification to insurance investigators.

To be considered, you must have a bachelor’s degree and at least three years of experience in insurance fraud. Those without a bachelor’s degree must have at least 10 years of insurance industry experience. You must pass an exam covering insurance fraud terminology, and an organized fraud case study. This exam must also cover software utilization, and medical fraud case study to earn your CIFI certification.

Insurance investigators can also obtain the Association of Certified Fraud Examiners’ Certified Fraud Examiner (CFE) certification.

To obtain this credential, you must pass an exam that covers fraud prevention and deterrence law. This is related to conducting fraud examinations, financial transactions and fraud schemes, and interviews and information gathering.

Gain Relevant Experience

Experience in the field is required to become a successful claims investigator. This experience can be gained through internships during your studies. It can also be gained by finding a job in the industry after graduation.

You will learn how to investigate claims and identify fraudulent behavior by gaining hands-on experience. You will also build relationships with other professionals who can provide valuable networking opportunities.

Working in the insurance industry before pursuing a position as an insurance investigator can be beneficial. Prior experience in law enforcement, can help you improve your interview skills, learn about insurance laws, and so on.

Those with relevant work experience are more likely to be hired. New insurance investigators typically receive on-the-job training. This begins with simple cases under the supervision of experienced investigators before moving on to more difficult cases.

Insurance Claim Investigator Salary

A Claims Insurance Investigator’s Salary will typically range from $41,950 to about $103,610 per year. However, this depends on education and experience.

Insurance Claim Investigator Jobs

Insurance investigators are typically employed by a private consulting firm, company, or government agency.

Insurance Claims Investigator Jobs are available in different insurance sectors. They  frequently work in the following insurance companies

  • Auto insurance companies
  • Health insurance companies
  • Homeowner’s insurance companies
  • Life insurance companies
  • Property insurance companies
  • Unemployment insurance companies and so on.

What Does an Insurance Investigator Do?

Insurance investigators investigate suspicious insurance claims in order to determine their legitimacy. Suspected criminal activity such as unnecessary medical treatments, and staged accidents are among the claims being investigated.

The insurance investigator begins the investigation by gathering and reviewing relevant documents. They then question the victim and witnesses in order to obtain a statement. To determine whether a reported injury is true, insurance investigators may conduct surveillance and social media tracking on the claimant.

This is done to see if they do anything that suggests they do not have an injury. Other common insurance investigator tasks include:

  • Surveying the incident site to gather information and examine damaged goods
  • Consultation with law enforcement and experts on data gathered
  • Examining the claimant’s criminal history and credit history

The insurance investigator writes a report of their findings and sends it to legal professionals once the investigation is completed. Depending on the circumstances, the insurance investigator may be called to testify in court about their findings.

Insurance Investigator Courses

In order to become an insurance claim investigator, it is important to go through some insurance investigator courses. However, it is not mandatory. It will only distinguish you from your contemporaries.

In addition, the International Association of Special Investigation Units, offers optional certification as a Certified Fraud Investigator. To qualify for SIU investigator training and the certified insurance fraud investigator credential, you must have a bachelor’s degree.

Relevant work experience is also required.  You must also agree to a code of ethics and pass an exam. Continuing education units are required to keep your certification as an insurance fraud investigator in good standing.

Auto Insurance Investigator Jobs

Many auto insurance companies provide job opportunities for insurance investigators related to their field. After fulfilling all the necessary requirements, simply apply for the desired position in an auto insurance company.

You can apply for the position of insurance investigator either online or by visiting an insurance company in need of investigators.


Do you need a license to be a private investigator?

You can get a Private Investigator’s license if you don’t have a criminal record. However, it’s not required and you can work as a Private Investigator without one.

How Do Insurance Companies Conduct Claims Investigations?

Insurance claims investigations use evidence, interviews, and records to determine whether a claim is legitimate or not. Depending on the type of claim, there are several types of insurance investigations.

What Makes a Good Insurance Investigator?

A successful insurance investigator is one who is well-versed in insurance law. Because insurance investigators conduct numerous interviews, strong communication and active listening skills are essential. Other abilities you may require include organizational skills.

What Does It Mean When Your Insurance Claim Is Under Investigation?

When an insurance company says “investigation,” you may think it’s an investigation to process the claim. However, it’s actually a tactic used by insurance companies to evaluate you and decide how they will handle the claim.

This tactic is also used to determine how they can get away with not paying on the claim.

How Long Does It Take for An Insurance Company to Investigate a Claim?

In general, the insurance company has 30 days to investigate your auto insurance claim. Although, this varies by state.



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