What are the requirements for insurance fraud investigation?

In Washington, insurance fraud investigation is a serious business. Insurance companies, law enforcement agencies and state regulators are all involved in the investigation of insurance fraud. To begin an investigation, there must be a reasonable suspicion of insurance fraud. This means that a law enforcement agency or insurance company must have reasonable grounds to believe that fraud has been committed. Once an investigation is opened, a variety of methods may be used to uncover evidence of fraud. This could include interviews, document analysis, surveillance and analysis of financial records. In Washington, investigators must adhere to strict ethical standards to ensure the integrity of the investigation. These standards include maintaining the confidentiality of documents and other evidence obtained, not conducting improper surveillance, and not using any of the evidence obtained in an investigation in any way that could be considered as harassment. Once an investigation has been completed, the results of the investigation must be reported to the Washington State Insurance Commissioner’s Office. The Commissioner’s Office will then determine if there is sufficient evidence of fraud to prosecute the alleged offender. If the evidence warrants prosecution, then the case will be referred to the State Attorney General’s office to prosecute. The Office of the Attorney General will then work with law enforcement to investigate and prosecute the case.

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What are the requirements for insurance fraud investigation?

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