Are you one of those who love taking risks? Do you love travelling extensively? Do you enjoy flirting with death, even if the job is low paying? If the answer to all the three questions are a yes, then the job of an insurance claims investigator is just what you are looking for.
Two months back, a claims investigator in Bihar was digging deeper into a death claim filed by an individual, when he suddenly disappeared. He had been working on the case for more than three months. Due to the delay, the insurer had to pay the claim amount of Rs 5 lakh. After a few weeks, it turns out that this individual was kidnapped and released only after the insurance money came through.
A claims investigator plays a crucial role in the life insurance sector. Whenever a death claim is filed and there are no proper supporting documents, the investigator is required to visit the claimant’s residence as also ascertain the circumstances following the death. The job of a claim investigator is to review life insurance claims that look suspicious. The investigator, an individual or a specialist company official, carries out a thorough study to determine the veracity of a death claim.
According to IRDAI (Protection of Policyholder’s Interests) Regulations 2017, once a life insurer receives a death claim, they have to process the claim without delay. They have to either pay or repudiate the claim in 30 days. However, where the circumstances of a claim warrant an investigation in the opinion of the insurer, they are required to initiate the same at the earliest and complete such investigation within 90 days.
Out of the total number of claims filed every year, it is anticipated that at least 10% of them are related to frauds. Since insurance works on a pool concept, it is the hard earned money of policyholders paid as premiums that is being used to pay for frauds.
Physical intimidation of investigators is a common complaint. There have been multiple cases of attacks, kidnapping and even death of investigators. Independent agencies appoint them in their teams and insurers avail of their services as and when needed.
Anecdotal evidence from insurance sources that Moneycontrol spoke to tell of incidents of investigators fleeing from on-field assignments. One particular such event in Odisha involved a professional who was attacked with about 20 snakes when he was investigating an Rs 6 lakh death claim of a 40-year man. The case is still pending.
Similarly, a gang of four men gagged an investigator and threatened to slap him with a prostitution racket case in Andhra Pradesh. The individual refused to investigate the claim any further citing ‘difficulties of terrain’. The claim was partially paid by the insurance company. The local police and a medical profession were also said to be allegedly involved in this racket.
Unlike Europe and the US, salaries for an investigator in India aren’t attractive. A starting salary of Rs 30,000 to 35,000 for a job with the risk of losing your life is what an insurance claims investigator position offers. Jobs are plenty in this field. Almost 10,000 positions are vacant at any point. But the issue is nobody seems to want to apply.moneycontrol