High School

In high school, take classes in business, chemistry, physics, biology, psychology, mathematics, criminal justice, and computer science. Since fraud investigators need strong writing and oral communication skills, be sure to take speech and English courses.

Postsecondary Education

There is no specific degree that prepares people to work as insurance fraud investigators, but many earn degrees in insurance, risk management, or business. Many investigators have backgrounds in law enforcement or fire investigation (and have degrees in criminology, criminal justice, or fire science and investigation). Most large insurance companies have their own training programs for new employees. 

Certification

Some colleges offer certificates in fraud and data analytics, law enforcement investigation, fire investigation, insurance, risk management, and related areas. Contact schools in your area to learn about available programs.  

Other Education or Training

The Association of Certified Fraud Examiners offers online and in-person continuing education opportunities. Recent online classes include Data Analysis Techniques for Fraud Examiners, Overcoming Bias in Investigations and Audits, Inside the Fraudster’s Mind, and Interviewing Witnesses and Suspects. The International Association of Special Investigation Units offers webinars and seminars at its annual conference.

Certification or Licensing

Insurance fraud investigators who are certified typically earn higher salaries, are more attractive job candidates, and have better chances of being promoted than those who are not certified. The Association of Certified Fraud Examiners awards the certified fraud examiner credential to members who meet minimum academic and professional requirements and pass an examination.

The International Association of Special Investigation Units awards three certification credentials: certified insurance fraud investigator, certified insurance fraud analyst, and certified insurance fraud representative. Applicants must meet education and experience requirements, and pass an examination.

Other Requirements

Aspiring insurance fraud investigators must undergo a background check, which may include a drug test.

Insurance fraud investigators need at least one to three years of experience investigating insurance claims or law enforcement investigative experience (ideally in fraud or identity theft units).

To be a successful investigator, you’ll need excellent interviewing, communication, and listening skills; knowledge of insurance and investigative practices; the ability to organize and evaluate data; and strong analytical, problem-solving, research, and computer and Internet skills. Insurance fraud investigators also need familiarity with the following types of software (although specific software proficiency requirements vary by employer):

• analytical or scientific software: insurance claims fraud detection software, behavioral targeting software
• computer-aided design software
  
• document management software
  
• expert system software: bill review software
  
• financial analysis software