How do insurance companies investigate fraud?

Insurance fraud is a major problem throughout the United States, including in Oregon, and insurance companies take a variety of steps to investigate fraud. Insurance companies have sophisticated computer systems and pay close attention to consumer complaints to look for potential fraud. If a suspicious claim is identified, the insurance company may hire an investigation firm to look into the matter further. These investigations can involve in-depth research, surveillance and data-mining. The investigators may look into the customer’s background, combing through public records to look for any discrepancies between what the customer reported and what is actually true. They may also look for any unusual activity related to the policy. In addition, investigators can use undercover operations and interviews to get more information. They may also conduct field investigations to look for any evidence that the insurance claim is not legitimate. In some cases, insurance companies turn the information over to law enforcement and state or federal prosecutors. The insurer can then offer a reward to those who provided the initial tips that led to the fraud being discovered and prosecuted. In Oregon, the National Insurance Crime Bureau, part of the National Insurance Crime Bureau, is part of a network to investigate insurance fraud. The NICB works with Oregon’s insurance companies and state law enforcement to uncover fraud and bring wrongdoers to justice.

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