Insurance Fraud Investigator

Insurance Fraud Investigator handles technical operations and this page lists 20 real tasks that reveal practical skills and common troubleshooting steps. The tasks reference tools like Microsoft Word and typical error signs. Each one shows where we found it, and comes with an AI prompt you can copy and use straight away.

20evidenced tasks
20ready prompts
9tools of the trade
13-2099.04O*NET-SOC code
132,130hold this job (US, BLS 2025)
$81,100median pay/yr (US)
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What it pays

Government survey numbers — not estimates, not ads.

Half of all Financial Specialists, All Other in the U.S. earn more than $81,100 a year — the middle 80% land between $48,460 and $151,490. About 132,130 people in the U.S. do this work. Figures are for the U.S. occupation group “Financial Specialists, All Other”. (U.S. Bureau of Labor Statistics survey, published 2025.) In India, Professionals earn about ₹38,298 a month on average — around ₹4.6 lakh a year (government PLFS survey via ILOSTAT, occupation-family figure).
$81,100typical pay / year
132,130people in this work
$151,490+top 10% earn
₹4.6 lakha year in India (family avg)
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The work, task by task

These are the real jobs-to-be-done, not a wish list. Each task shows where we found it, and the prompt underneath is written for that exact task.

Keeping the record2

Gather financial documents

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Obtain the last three years of bank statements, credit card reconciliations, and payroll ledgers for claimant…
Obtain the last three years of bank statements, credit card reconciliations, and payroll ledgers for claimant Sarah Lopez, index them by date, flag suspicious transfers over $5,000, and upload the packet for the audit team before close of business Thursday.
The tools that do the workMicrosoft OutlookMicrosoft ExcelESCOjob descriptionsO*NET

Obtain evidence

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Collect phone records, CCTV clips, the insurance claim form, contractor invoices and the signed project…
Collect phone records, CCTV clips, the insurance claim form, contractor invoices and the signed project contract for claim number 2026-4512, verify timestamps against bank deposits, and assemble a numbered evidence binder for chain-of-custody submission tomorrow morning.
The tools that do the workMicrosoft WordMicrosoft OutlookESCOjob descriptionsO*NET
Analysing2

Detect securities fraud and market abuse

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Run transaction patterns for broker account 77-3348 for the last 18 months, flag wash trades and outlier…
Run transaction patterns for broker account 77-3348 for the last 18 months, flag wash trades and outlier pricing, export the suspicious-trade list with supporting invoices and attach a misconduct brief for the supervisor by Monday noon.
The tools that do the workPythonMicrosoft ExcelESCOO*NET

Interview witnesses or suspects

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Schedule and conduct a protective interview with witness Jorge Ramos at 2 p.m. Wednesday in Conference Room…
Schedule and conduct a protective interview with witness Jorge Ramos at 2 p.m. Wednesday in Conference Room B, prepare the Miranda and consent advisories, record the session, take contemporaneous notes, and send the signed interview record to the case file by end of day.
The tools that do the workMicrosoft WordMicrosoft Outlookjob descriptionsO*NET
The daily work16

Recommend actions in fraud cases.

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Recommend a course of action on the Patel Group case: list priority charges supported by the accounting…
Recommend a course of action on the Patel Group case: list priority charges supported by the accounting anomalies, the documents we must subpoena, a recommended freeze on accounts if legal threshold met, and two next investigative steps for manager review by Wednesday.
The tools that do the workMicrosoft WordO*NET

Conduct in-depth investigations of suspicious financial activity, such as suspected money-laundering efforts.

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Lead a deep-dive on the Patel Group suspected laundering: map fund flows from the insurance payouts to…
Lead a deep-dive on the Patel Group suspected laundering: map fund flows from the insurance payouts to beneficiary accounts, identify three suspicious transaction patterns, flag entities needing subpoena, and propose forensic accounting tests for my manager by Friday.
The tools that do the workPythonMicrosoft ExcelO*NET

Obtain and serve subpoenas.

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Prepare and serve subpoenas for the Patel Group investigation: assemble the list of records and custodians,…
Prepare and serve subpoenas for the Patel Group investigation: assemble the list of records and custodians, draft three subpoenas naming the insurer, bank, and shell company, get legal sign-off, and schedule service with the process server for next Monday.
The tools that do the workMicrosoft WordO*NET

Arrest individuals to be charged with fraud.

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Plan the arrest operation for subject R. Singh: confirm charges supported by the financial audit, secure…
Plan the arrest operation for subject R. Singh: confirm charges supported by the financial audit, secure prosecutor approval, assign arrest team, establish evidence custody procedures, and set the arrest window for Thursday morning to minimise flight risk.
The tools that do the workMicrosoft OutlookMicrosoft WordO*NET

Take statements

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Take witness statements from claims manager Aisha Khan and adjuster Tom Reed: prepare tailored question sets,…
Take witness statements from claims manager Aisha Khan and adjuster Tom Reed: prepare tailored question sets, record signed contemporaneous statements, check for contradictions with the ledger entries, and upload final statements to the case file today.
The tools that do the workMicrosoft WordMicrosoft SharePointjob descriptions

Produce reports

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Produce the Patel Group investigation report: combine timeline, audited ledger discrepancies, bank trace…
Produce the Patel Group investigation report: combine timeline, audited ledger discrepancies, bank trace charts, witness statements, and legal recommendations into a single executive report and send to the regional fraud manager by Friday midday.
The tools that do the workMicrosoft PowerPointMicrosoft Wordjob descriptions

Testify to findings

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Testify at the tribunal next Wednesday to my fraud investigation findings: present the timeline of…
Testify at the tribunal next Wednesday to my fraud investigation findings: present the timeline of transactions, explain the forensic audit steps, attach the signed evidence bundle and a one-page executive summary, and confirm I can be cross‑examined for up to one hour.
The tools that do the workMicrosoft WordMicrosoft Outlookjob descriptions

Manage fraud risk assessments

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Update the department fraud risk assessment today: incorporate the latest suspicious activity trends,…
Update the department fraud risk assessment today: incorporate the latest suspicious activity trends, recalculate exposure by line of business, list top three control gaps with proposed remediation owners and deadlines, then circulate to the risk manager for sign‑off.
The tools that do the workMicrosoft ExcelMicrosoft SharePointESCO

Liaise with regulatory bodies

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Prepare a formal liaison package for the regulator: summarise case volumes and outcomes this quarter,…
Prepare a formal liaison package for the regulator: summarise case volumes and outcomes this quarter, describe our escalation criteria, include redacted sample files and our cooperation point of contact, then request a compliance meeting next Tuesday morning.
The tools that do the workMicrosoft WordMicrosoft OutlookESCO

Liaise with managers

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Organise a managers' briefing for Friday: draft a one‑page incident summary, prepare a two‑slide dashboard of…
Organise a managers' briefing for Friday: draft a one‑page incident summary, prepare a two‑slide dashboard of active investigations by severity, list decisions needed from each manager and book a 45‑minute slot with the regional claims head.
The tools that do the workMicrosoft PowerPointMicrosoft OutlookESCOsee the evidence ↗

Interpret financial statements

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Analyse the claimant's balance sheet and cashflow this afternoon: highlight unusual receivable patterns,…
Analyse the claimant's balance sheet and cashflow this afternoon: highlight unusual receivable patterns, reconcile reported income to bank traces, produce a one‑page findings note showing indicators of diversion and suggested evidence traces to pursue.
The tools that do the workMicrosoft ExcelMicrosoft WordESCOsee the evidence ↗

Interpret law

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Draft a legal interpretation memo on policy exclusions before COB today: cite the relevant statutes and…
Draft a legal interpretation memo on policy exclusions before COB today: cite the relevant statutes and precedent, explain how exclusions apply to staged accidents, assess litigation risk, and recommend whether to deny cover or seek counsel review.
The tools that do the workMicrosoft WordESCOsee the evidence ↗

Conduct financial audits

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Run a full financial audit of the Markham claims unit for fiscal year 2025: pull ledgers and bank feeds,…
Run a full financial audit of the Markham claims unit for fiscal year 2025: pull ledgers and bank feeds, reconcile claimant payments to invoices, flag unexplained variances over $2,000, and prepare a one‑page findings brief for my manager by Tuesday morning.
The tools that do the workMicrosoft ExcelMicrosoft AccessESCOsee the evidence ↗

Trace financial transactions

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Trace all transactions tied to policyholder account 44321 from January through June 2025: map incoming…
Trace all transactions tied to policyholder account 44321 from January through June 2025: map incoming premiums and outgoing payouts, identify third‑party transfers and shell accounts, and produce a chronological transaction trail with supporting source documents for the investigator file.
The tools that do the workMicrosoft SQL ServerMicrosoft ExcelESCOsee the evidence ↗

Financial statements

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Draft an annotated set of the latest financial statements for suspect provider North Shore Rehab: verify…
Draft an annotated set of the latest financial statements for suspect provider North Shore Rehab: verify revenue recognition, highlight abnormal receivable days and related party balances, and write three bullet points on legal implications for referral to counsel.
The tools that do the workMicrosoft WordSASESCOsee the evidence ↗

Manage corporate bank accounts

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Compile and monitor the corporate bank accounts list, confirm signatories and balance thresholds, set alerts…
Compile and monitor the corporate bank accounts list, confirm signatories and balance thresholds, set alerts for transfers above $10,000, and prepare an exceptions log for the finance director to review every Friday.
The tools that do the workMicrosoft SharePointMicrosoft OutlookESCOsee the evidence ↗

Says who?

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The logs, files & records this job keeps

Shared with other careers — the same record means something different in each.

Related careers

Same family of work — each with its own tasks and prompts.

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