Signs You May Be Dealing With Insurance Fraud and What to Do
Insurance fraud is far more common than many people realize. From exaggerated injury
claims to staged accidents and falsified documentation, fraudulent activity costs insurers
and businesses billions of dollars each year. It also drives up premiums for honest
policyholders and complicates legitimate claims.
Below are some of the most common signs of insurance fraud and the steps you should take
if something doesn’t feel right.
Common Red Flags of Insurance Fraud
1. Inconsistent Statements or Changing Details
One of the earliest warning signs is a claimant whose story changes over time. This may
include conflicting accounts, different timelines, or details that shift when questioned.
2. Delayed Reporting or Last-Minute Claims
Fraudulent claims are often reported well after the alleged incident, immediately before a
policy lapse, or shortly after coverage increases.
3. Lack of Independent Witnesses or Documentation
Claims relying solely on the claimant’s account without witnesses or official documentation
warrant closer scrutiny.
4. Suspicious Medical or Repair Patterns
Excessive treatment, repeated providers across claims, or unusually high repair estimates
may indicate inflated losses or collusion.
5. Prior Claims History
Frequent or repetitive claims—especially similar ones—can signal potential fraud patterns.
What Not to Do When You Suspect Fraud: Avoid accusing claimants directly, conducting unauthorized surveillance, gathering
evidence illegally, or sharing suspicions without documentation.
What to Do Instead: Document everything, preserve all evidence, and consult professionals early.
How Professional Investigations Help
Licensed private investigators conduct lawful surveillance, verify claims, locate witnesses,
and prepare court-ready reports. Not every questionable claim is fraudulent, but ignoring red flags can be costly.
Verification, not confrontation, is key.
Investigations America specializes in discreet, legally compliant insurance fraud
investigations that uncover facts and support informed decisions.