Insurance fraud investigator
Also known as: insurance fraud inspector, insurance policy processing worker, insurance examiners, insurance inspectors, insurance auditors, insurance fraud auditor
About this occupation
Insurance fraud investigators combat fraudulent activities by investigating the circumstances of certain suspicious claims, activities related to new customers, buying insurance products and premium calculations. Insurance fraud investigators refer potential fraud claims to insurance investigators who then undertake research and investigations to support or deny a claimant's case.
Essential skills and knowledge
- actuarial science
- interview insurance claimants
- types of insurance
- conduct financial audits
- insurance law
- assist police investigations
- analyse claim files
- detect financial crime
- principles of insurance
- review insurance process
- claims procedures
- assess customer credibility
Typical tasks and preparation
From the related US occupation profile Fraud Examiners, Investigators and Analysts (O*NET 13-2099.04). Linked by an official crosswalk: related, not identical; details vary by country.
- Document all investigative activities.
- Create and maintain logs, records, or databases of information about fraudulent activity.
- Prepare written reports of investigation findings.
- Interview witnesses or suspects and take statements.
- Gather financial documents related to investigations.
- Analyze financial data to detect irregularities in areas such as billing trends, financial relationships, and regulatory compliance procedures.
- Preparation
- Job Zone 4 of 5
- Interests
- Conventional, Investigative, Enterprising
Top skills: Active Listening, Writing, Reading Comprehension, Speaking, Critical Thinking, Judgment and Decision Making
US median pay: US$81,100 a year (2025), 132,130 employed. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics.
Subjects this work relies on
How important each subject's knowledge is in the job itself, rated by people doing it (1 to 5).
- English or Literature in EnglishO*NET: English LanguageVery important (4.4)
- Government and PoliticsO*NET: Law and GovernmentVery important (4.1)
- Economics or AccountingO*NET: Economics and AccountingVery important (3.6)
- Mathematics or StatisticsO*NET: MathematicsImportant (3.0)
- PsychologyO*NET: PsychologyImportant (3.0)
O*NET data describe work in the United States; requirements differ by country. This page includes information from the O*NET 31.0 Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA). Used under the CC BY 4.0 license. O*NET is a trademark of USDOL/ETA. CareerProof Global has modified all or some of this information; USDOL/ETA has not approved, endorsed, or tested these modifications.
Preparation needed
Job Zone Four: Considerable Preparation Needed
- Education
- Most of these occupations require a four-year bachelor's degree, but some do not.
- Experience
- A considerable amount of work-related skill, knowledge, or experience is needed for these occupations. For example, an accountant must complete four years of college and work for several years in accounting to be considered qualified.
- Training
- Employees in these occupations usually need several years of work-related experience, on-the-job training, and/or vocational training.
O*NET data describe work in the United States; requirements differ by country. This page includes information from the O*NET 31.0 Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA). Used under the CC BY 4.0 license. O*NET is a trademark of USDOL/ETA. CareerProof Global has modified all or some of this information; USDOL/ETA has not approved, endorsed, or tested these modifications.
Related occupations
Occupations O*NET links to this one by similar work, skills and knowledge.
- Private Detectives and Investigators
- Financial Examiners
- Detectives and Criminal Investigators
- Compliance Managers
- Intelligence Analysts
- Retail Loss Prevention Specialists
- Police Identification and Records Officers
- Claims Adjusters, Examiners, and Investigators
- Accountants and Auditors
- Lawyers
O*NET data describe work in the United States; requirements differ by country. This page includes information from the O*NET 31.0 Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA). Used under the CC BY 4.0 license. O*NET is a trademark of USDOL/ETA. CareerProof Global has modified all or some of this information; USDOL/ETA has not approved, endorsed, or tested these modifications.