Insurance fraud results in around $308 billion stolen each year in the U.S.1 Consumers feel the impact of this massive theft through higher premiums. Excluding health insurance, the FBI estimates insurance fraud costs the average American family between $400 and $700 a year.2 ZCIS works to help protect our customers from being victims of insurance fraud and help fight its costly impacts on our industry.
How does claims investigation work?
Our nationwide network of experienced field investigators and specialists is trained to confirm the legitimacy of claims and to identify, diligently pursue and deter fraudulent activity across multiple lines of insurance business. ZCIS supports Zurich’s Claims unit by providing fraud-related information to support timely, fair and accurate claims decisions and recovery of payments made on fraudulent claims.
How does ZCIS excel in claims investigation?
Our team members hold designations as Certified Fraud Examiners, Certified Insurance Fraud Investigators, Fraud Claim Law Specialists, Associates in Claims and Senior Claim Law Associates. Our investigators have deep knowledge of all common areas of fraud, including but not limited to:
- Bodily injury
- Heavy equipment theft
- Incendiary fires
- Medical provider referral schemes
- Medical provider billing practices
- Organized ring activity
- Staged accidents
- Vehicle theft
- Vehicle finance fraud
We use a wide range of resources to reveal fraud and call on an extensive network of highly qualified vendors to help with:
- Surveillance
- In-person statements
- Mobile device and vehicle “infotainment” forensics
- Accident reconstruction and injury analysis
- Medical, pharmaceutical and other canvasses
- Innovative new tools to aid in decision-making
ZCIS is collaborating with Zurich’s Data and Analytics Team on a state-of-the-art, case management system to enhance communications throughout our Claims team and make investigations even more efficient. This complements our longstanding use of cutting-edge technology and strategic data application.
We work with knowledgable authorities and organizations.
In addition to working closely with our customers and local, state and federal law enforcement agencies, ZCIS is a member of:
- Coalition Against Insurance Fraud
- International Association of Special Investigation Units
- International Association of Auto Theft Investigators
- International Association of Arson Investigators
- National Insurance Crime Bureau
Learn more about how ZCIS works to combat insurance fraud
1. Coalition Against Insurance Fraud. “About Fraud” webpage. Accessed 23 September 2021.
2. Federal Bureau of Investigation. “Insurance Fraud” webpage. Accessed 23 September 2021.
This is intended as a general description of certain services available to qualified customers through the companies of Zurich in North America, provided solely for informational purposes. Zurich does not guarantee a particular outcome, reduction in costs, or improvement in administration or safety and further assumes no liability in connection with the providing of these services.