What should an adjuster do if they encounter fraud during a claim investigation?

When an adjuster encounters potential fraud during a claim investigation, the appropriate course of action is to report it to the insurer and local authorities as appropriate. This is essential because fraudulent activities can significantly impact the integrity of the insurance process and the financial stability of the insurance company. By reporting the suspected fraud, the adjuster upholds their ethical responsibilities and ensures that the claim is reviewed thoroughly and fairly.

Notifying the insurer allows the company to take necessary steps to investigate the fraudulent activity, which may include employing special investigation units and possibly involving law enforcement, if needed. This also protects the rights of all parties involved and helps maintain the overall trust in the insurance system.

Recognizing and addressing fraud is critical in preventing financial losses for the insurer and ensuring that legitimate claims are honored without the influence of dishonest behavior.