Insurance Fraud Investigations
When a claim does not add up, we get the facts.
Staged accidents, padded claims, and workers' compensation and disability fraud, documented with lawful surveillance and investigation. Former FBI agents and attorneys. Built for court. Licensed in New York State.
Former FBIAttorney LedLicensed in New York State
The Crime We All Pay For
Insurance fraud is not victimless. It is expensive.
Every staged accident and padded claim gets paid for by honest policyholders. The figures below show the scale of the problem and who really covers the cost.
$308.6B
the annual cost of insurance fraud in the U.S.
$3,750
the hidden cost to the average family every year
10%
of property and casualty claims involve fraud
$34B
lost to workers' compensation fraud a year
Sources: Coalition Against Insurance Fraud (2022); National Insurance Crime Bureau.
A Growing Problem
The cost has exploded, and it is still climbing.
The last time anyone measured the full cost of insurance fraud before 2022, the figure was $80 billion. Adjusted for inflation, that would be about $155 billion today. The real number came in at $308.6 billion, nearly double the inflation-adjusted figure, because fraud has spread into more lines and grown more sophisticated. It is not a fringe problem. It is a rising cost built into every premium.
The rising cost of insurance fraud in the U.S.
Even after adjusting for inflation, the real cost is nearly double.
1995 estimate$80B
1995 estimate, adjusted for inflation$155B
2022 actual cost$308.6B
Source: Coalition Against Insurance Fraud, 2022.
Where We Come In
The claims we investigate, by the numbers.
Insurance fraud shows up across every line, but a few account for most of the work: property and casualty claims, workers' compensation, and auto. These are the cases where a careful investigation and lawful surveillance make the difference between paying a manufactured claim and proving what really happened.
Annual fraud cost in the lines we investigate
Property, casualty, and workers' compensation lead the claims we work.
Property & casualty$45B
Workers' compensation$34B
Auto theft$7.4B
Source: Coalition Against Insurance Fraud, 2022.
The Claims We Watch
Most workers' comp fraud is a story surveillance can disprove.
A claimant says they cannot lift, bend, or return to work. Lawful surveillance shows what they actually do on an ordinary day. When the two do not match, the claim falls apart. Most workers' compensation fraud is claims fraud of exactly this kind, an exaggerated or false injury, rather than an employer underreporting payroll. That gap, between what is claimed and what is true, is what we document.
Workers' compensation fraud, by type
Most of it is claims fraud, the kind surveillance is built to catch.
Claims fraud · exaggerated or false injuries$25B
Premium fraud · employer underreporting$9B
Source: Coalition Against Insurance Fraud, 2022.
What We Investigate
The cases we handle.
Insurance fraud runs from a single padded claim to organized staged accident rings. The National Insurance Crime Bureau estimates that around one in ten property and casualty claims involves some element of fraud. We work for carriers, special investigation units, third party administrators, self insured employers, and defense counsel, building the record that separates a legitimate loss from a manufactured one.
Staged & caused accidentsExaggerated injury claimsWorkers' compensation fraudDisability & malingeringProperty, fire & arson claimsSlip and fall claimsMedical & billing fraudClaimant activity checks
Our Process
How an insurance fraud investigation works.
Every engagement is confidential and built to hold up if it ends in court or in front of a regulator.
01
Confidential consultation and claim review
We review the claim file, the red flags, and your goals with the carrier or counsel, and map the fastest path to answers, all under strict confidentiality.
02
Claim and background investigation
We verify the facts, check prior claims history and public records, and identify inconsistencies that point to where surveillance will matter most.
03
Covert surveillance and activity checks
We document the claimant's actual physical activity with lawful, time stamped video, compared against the limitations they have claimed.
04
Scene and evidence work
Where it helps, we canvass witnesses, examine the loss scene, and develop leads on providers, vehicles, and organized activity.
05
Interviews and recorded statements
We conduct structured interviews and take recorded statements to lock down accounts before they can shift.
06
Court-ready reporting and testimony
You receive a clear, SIU ready report with documented video and findings, and expert testimony that stands up to cross examination.
Watch
A short look at how an insurance fraud investigation comes together.
Why Insight
Federal experience. Legal discipline. Evidence that holds.
Our team brings more than 70 years of combined investigative, intelligence, and legal experience to the private sector.
Former FBI and national security
Our investigators come from the FBI and national security backgrounds, trained in financial crime, fraud, and complex investigations.
Attorney led, built for court
Attorneys guide every case, so surveillance and findings meet the standards an SIU, a claim file, or a courtroom will demand.
Licensed in New York State
We are fully licensed New York State investigators, working within state privacy and surveillance law so the evidence holds up.
Discreet, neutral, defensible
We work quietly and report only what the evidence supports, which is what makes our findings hold up under scrutiny.
Questions
Common questions about insurance fraud investigations.
What kinds of insurance fraud do you investigate?
We handle false and exaggerated claims across the property and casualty world: staged and caused accidents, inflated injury and disability claims, workers' compensation fraud, slip and fall claims, property, fire, and arson claims, and organized fraud rings. We work for carriers, special investigation units, third party administrators, self insured employers, and defense counsel.
How does surveillance prove a fraudulent claim?
A claimant describes what they can no longer do. We document what they actually do on ordinary days with lawful, time stamped video. When someone who claims they cannot work is filmed doing physical labor, the record speaks for itself and gives the carrier and counsel a factual basis to act.
Is the surveillance legal?
Yes. We are licensed New York State investigators and we work strictly within state privacy and surveillance law. We document what is observable from lawful vantage points, without trespass or unlawful recording, which is exactly what keeps the evidence admissible.
Who do you work with, and can you support litigation?
We work with insurers, special investigation units, third party administrators, self insured employers, and defense attorneys. Our reports are built to support claim decisions and litigation, with documented video, clear findings, and expert testimony when it is needed.
If a claim feels wrong, let us document the truth.
Speak with a licensed New York State investigator today, in complete confidence. Former FBI, attorney led, and built for court.
Sources & Data
Coalition Against Insurance Fraud, The Impact of Insurance Fraud on the U.S. Economy (2022), researched by Colorado State University Global. Total annual cost of $308.6 billion, the per family cost, line breakdowns for property and casualty, workers' compensation, and auto theft, and the growth from the 1995 estimate.
National Insurance Crime Bureau (NICB). Estimate that roughly one in ten property and casualty claims involves fraud.
Statistics on this page reflect United States data as reported by the sources above.
Former FBI professionals, attorneys, and national security experts delivering high-integrity private investigations built for legal, corporate, and high-risk environments.
INSIGHTS
- The Insider Threat Sitting Inside Your Company Right Now
- Due Diligence Failures That Cost Companies Millions
- Before You Sue, Know the Facts: Why Smart Attorneys Use Investigators Before Filing
- Social Media Never Forgets: How Digital Investigations Expose Contradictions
- The CFO Is Not the Only Risk: How Internal Fraud Hides in Plain Sight
Reach Us
We are diligent and determined because we care about our clients.
1335 Jefferson Rd, Rochester, NY 14623