Insurance Investigator Resume Sample & Ready To Use Example

Insurance Investigator

Extensive experience of XX years inexamining claims forms and other records to determine insurance coverage; investigating and assessing damage to property and create or review property damage estimates
Adept in reviewingpolice reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability; negotiating claim settlements and recommend litigation when settlement cannot be negotiated
Deft in analyzinginformation gathered by investigation and report findings and recommendations; obtaining credit information from banks and other credit services; examining titles to property to determine validity and act as company agent in transactions with property owners

BBA, Bachelor of Business Administration, Completed, July 2003

ABC College

BBA

Delhi, Delhi

April 2004 - August 2010

Insurance Investigator

XYZ Ltd

Delhi, Delhi

Key Result Areas:

Investigate cases of arson, where fires may have beenset intentionally to cash in insurance claims.
Examine falsified workers' disability claims
Set up surveillance and attempt to catch people suspected of fraud in the act
Investigate possibly staged accidents; determine if medical treatments were necessary
Examine vehicular damage; verify claimant's identity
Visit claimants and witnesses to obtain an oral statement
Take photographs and document evidence
Examine videotapes to detect fraud; inspect facilities
Determine if doctors have a proper license
Consultwith legal counsel; testify as an expert witness in court case
Inspect damaged buildings and automobiles; investigate doctors suspected of malpractice
Create detailed reports documenting incidents; perform background checks
Examine medical reports

Key Highlights:

Any existing systems/ processes streamlined???? Results obtained????Major assignments handled????
Any unique initiative taken to improve customer satisfaction level? Any major accounts/clients handled?
Awards/appreciation letters received???? Other relevant achievements????

August 2011 - Current

Insurance Investigator

ABCD Ltd

Delhi, Delhi

Key Result Areas:

Conducted objective, fair, thorough, unbiased and timely investigations into allegations of fraud, waste or abuse committed by clients against ourcompany
Reviewed and researched evidence/documents to analyze the overall fact pattern of claim and synthesize data into a professional report with recommendations
Prepared and coordinated field assignments to obtain relevant evidence and information
Coordinated with defense attorneys to provide deposition strategies and use law enforcement resources for assistance
Managed and prioritized a large and varied case load effectively and efficiently to achieve positive results; prepared prosecution packages andrestitution proposals

Key Highlights:

Any existing systems/ processes streamlined???? Results obtained????Major assignments handled????
Any unique initiative taken to improvecustomer satisfaction level?Any major accounts/clients handled?
Awards/appreciation letters received???? Other relevant achievements????