Insurance Investigations

Insurance investigators estimate fraud to be  estimated to cost up to $2.2 billion every year, which is directly affecting premiums for genuine policyholders. 

Sydney, brisbane, Gold Coast

The Insurance Fraud Bureau of Australia estimates that in 2017, insurers detected $280 million in fraudulent claims in all classes of insurance, excluding WorkCover, CTP and Personal Injury claims. These figures are only what has been identified, and we know the amount is significantly more than that.

Insurance fraud affects those that have legitimate claims! Although insurers have systems in place to red flag suspect insurance claims, it is still necessary to conduct an insurance investigation to determine fraud and liability. Without detecting fraud, premiums for those individuals and business will continue to increase to counter balance the loss to insurers. 

Prime Investigations has been conducting insurance investigations into all areas of insurance including WorkCover, CTP, Public Liability, Personal Injury, Income Protection and Fire & Theft claims.  All of our insurance investigators have years of experience in their respective fields. 

variations of fraudulent claims

01

Deliberate

An insurance claim that is deliberately fraudulent is calculated and planned. The idea is to deceive the insurer and receive a payout or payments over time. For example, a policyholder along with another person stages a car accident, or burns down a house, or fakes a theft. This is not uncommon in the insurance world. This generally occurs more when the economy is down. 

02

Exaggeration

In this instance, the claimant does have a legitimate injury, or claim but then deliberately exxagarets the injury or the damage to assets. This is done to increase the payout figure. This can be quite common in CTP claims where the claimant will allege greater injury and impact to their lives to increase the payout considerably. Also common in WorkCover claims.

03

Non-Disclosure

This means that the claimant or policyholder has not provided all information to the insurer. It is quite common with personal injury claims, where the injury may be pre-existing or in the case of WorkCover, happened outside of the workplace. This also happens with vehicle insurance where the driver’s previous history is not disclosed.

quality Insurance Investigators

For more than a decade, we have been providing insurance investigations for self insurers, solicitors and businesses relating to WorkCover, CTP, Public Liability and Vehicle Accident Claims. 

Investigating insurance claims to identify fraud or legitimacy requires an investigator with a good head on their shoulders and experience in making the relevant inquiries. 

Our insurance investigators are smart, well spoken and experienced in handling many types of insurance related investigations. These attributes are especially important when handling claims where a physiological injury has been alleged. 

Claims we investigate

There are many forms of insurance these days and each one requires a different approach when it comes to investigating the claim and providing a factual report so qualified specialists can make a determination of liability.

We do not use inexperienced investigators to handle insurance related matters. Each investigator on our team has at least 5 years experience in their respective fields. Let us handle your next matter. 

  • CTP Insurance Claims
  • WorkCover Insurance Claims
  • Public Liability
  • Fire Damage
  • Theft
  • Income Protection

Investigation Types

The three cores  services that are used to investigate insurance claims are below. Depending on what our clients requirements are, we are able to assign an investigator with these specific skills to investigate and report back. We provide professional reports for those qualified to make a judgement on the matter as to liability. 

  • Surveillance

A well planned surveillance operation can be very effective in gathering hard evidence in relation to insurance matters. Each agent we use has at least 5 years experience in the field and with insurance related matters. A good surveillance agent remains discreet and doesn’t alert people nearby as to their activities.

  • Factual

A good factual investigator has many attributes. The process of interviewing related parties, asking the right questions, appearing sensitive toward claimants etc are all part of conducting a professional investigation. Our factual investigators are smart, well mannered, professional, well spoken and have good writing skills. 

  • Online Intel

Online intelligence gathering, otherwise known as OSINT has proven to be very effective in helping to better understand someones background and activities. This can include their financial status, other employment, sporting activities and more, which can all be very helpful in determining the legitimacy of a claim.

let us investigate

A good investigator knows the principles of investigation methods required to uncover the facts.
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The world is full of obvious things which nobody by any chance ever observes. Arthur Conan Doyle
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Who We Are

Our Mission

We are a boutique investigation company, operating for over a decade, dedicated to providing quality investigations to self insurers, insurance companies, businesses and private individuals. Our focus is to provide customised investigative strategies to our clients to maximum results and over deliver on their expectations. Our goal is to maintain high satisfaction for our clients and continue to explore and advance in what is possible with investigation techniques and resources.

Our Team

Over the past decade, we have acquired some of Australia’s best private investigators, all whom are specialised in their respective fields. Our team are dedicated and experienced in many types of investigating, making us one of the premier private investigation companies in Australia. We now operate with over 70 investigators positioned through most of Australia’s major cities and outer areas, enabling us to cater for any matter any place and any time.

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Our Locations

Prime Investigations are located in Sydney, Brisbane and Gold Coast and have reach with affiliated investigators in Adelaide and Perth. With over 70 investigators nationwide, we can assist you no matter what the location.