Probably one of the biggest misconceptions about the world of “investigation” is the whole thing of there always being that ‘smoking gun’ that the investigator finds right there at the scene, just being dropped at that exact moment by the guilty party… Job’s a good ‘un – we’re all heading home for an early finish on a Friday afternoon!

The reality is decidedly less glamorous and actually much more arduous. Take a recent case we worked on in the matter of a high value insurance fraud.

If you’ve done any form of investigation for long enough you start to get a ‘feel’ or a ‘scent’ for when things are off or not at all what they seem to be. For us, we walked into this case and could quickly see that what the claimant was suggesting did not seem to add up and that our clients were going to be taking a considerable financial hit on this.

But the existence of ‘fraud’ per se just wasn’t there, staring us in the face and waiting for us to grab it, tag it and present it back to all involved. There was things that didn’t seem quite right – but those things on their own are not strong grounds to void someone’s claim.

And that’s where the reality of investigation kicks in – We poured through witness statements and listed the inconsistencies. We got out there and knocked on doors. We submitted the Section 29 and Section 35 requests. We ticked the boxes needing ticked and dotted all the i’s. And we waited on document disclosures to be released. And we waited and waited some more. Because no one works to your timeframe.

THEN you start consolidating it all and pouring over it… and before you know it you’ve stockpiled all the evidence to back up that things aren’t as the claimant originally said or that things could not have ever happened how you were told they did. Because a truly effective insurance fraud investigation requires absolute thoroughness.

As one of the wisest men we’ve ever known in the field of insurance fraud investigation told us back in the day when he was mentoring our team:

“… Go in with the idea that it’s a wholly legitimate insurance claim and just let your gut and what’s in front of you tell you differently if they need to.”