Insurance Fraud: Hiring a Fraud Investigator

Article Published:Feb 14

Insurance fraud is one of the most common types of fraudulent activities that continue to plague society, with thousands of people trying to cheat the system every year. In this piece we will briefly explore the important role of the fraud investigator when handling cases of this nature.

What is insurance fraud?

Insurance fraud is an act committed by the client of an insurance company whereby he or she deliberately attempts to illegitimately gain some financial benefit from their insurance provider. This is essentially stealing, and naturally a contravention of the law. A basic example of this would be a staged motor vehicle collision or staged theft of motor vehicle.

This type of fraud is more common than one might expect. One instance could be where a number of people travelling in a vehicle will purposely hit an innocent motorist. Following the accident the occupants of the vehicle will attempt to claim for any number of small, soft tissue injuries or possibly more serious injuries from the relevant medical aid or insurance provider. These types of fraudsters will often be “examined” by doctors who could have conspired with the group of perpetrators.

The role of the fraud investigator:

The role of the fraud investigator is simple: To investigate suspicious insurance claims and root out fraudsters. While this may seem quite straightforward on the surface, it is actually an incredibly difficult job. This is largely down to the fact that fraudsters are constantly coming up with new ways of trying to override the system dealing with insurance claims. These criminals can’t usually use the same scam twice, and are constantly evolving their techniques in order to pull the proverbial wool over both insurance companies’ as well as fraud investigators’ eyes.

The most common types of insurance fraud investigated by fraud agents include life insurance, health care insurance, exaggerated claims and motor vehicle insurance claims. It is also possible for private brokers or individuals to enlist a private investigator if they suspect fraudulent behaviour. For instance, some scammers fabricate injuries on duty at work or on third party premises; the employer or owner of the building in this case can also engage a private investigator to look into the merits of the case.

With the ever changing world of fraudulent activities, fraud investigators in South Africa remain as important as ever. We at D&K investigators also specialise in this field of insurance fraud, among various other areas. Contact us today for a competitive quote or simply visit our website for more useful information!

For trained bodyguards you can depend on when it comes to entrusting the safety of yourself, your family and even your property – you need not look further than D&K Investigators. Contact us today for a professional needs assessment and a competitive quotation.

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"Thanks to D&K, we were able to carry out a discreet investigation, simply and fast."
John Brown, BKR Attorneys - September 2003 Read more »