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Investigative Interviewing Techniques for Insurance Investigators

Investigative Interviewing Techniques for Insurance Investigators

Instructor: Cliff Crosby*

Claims adjusters and investigators secure statements from claim participants in a variety of different settings. Interviews can take place in the investigator’s vehicle in a parking lot. The investigator may have to take a statement at a person’s residence. And sometimes the only way for an investigator to secure an interview is by phone or in today’s environment, virtually. Regardless of the setting, there are a number of techniques that can be used in any situation in which a statement is needed.

We have developed a program that provides the insurance claim professional with these specific interviewing techniques. In this three-hour virtual training program you will learn how to structure the investigative interview for a variety of claims, including fire, theft, bodily injury and the Examination Under Oath.

You will also learn the indicators of claim misrepresentations, as well as the verbal and nonverbal subject behaviors that are indicative of truth or deception. The specific behaviors discussed include attitude; posture; significant posture changes; grooming, personal and protective gestures; eye contact; and, verbal responses. At the conclusion of this segment of the program, the participant will have a behavioral model for both the truthful and deceptive individual that can be used as a model for the evaluation of subjects in future investigative interviews.

We will also address specific telephone interviewing techniques, including the Opening, the Investigative Questions for a variety of claims, the use of Behavior-Provoking Questions and the interview Closing.

Whether you are a new investigator, claims adjuster, or a seasoned veteran, this program will significantly enhance your future investigative interviews and your ability to assess the credibility of the claim.

Table of Contents

  • Characteristics of an Interview

  • Interview Goals

  • The Interview Environment

  • The Structure of the Interview

  • Opening Statement

  • Investigative Questions

  • Clarification Questions

  • Closing the Interview

  • Documenting the Interview

  • Behavior Symptom Analysis

  • Attitude and Demeanor

  • Nonverbal Behaviors

  • Verbal Behaviors

  • Paralinguistic Behaviors

  • Questions to ask re:
    • Examination Under Oath
      • General Red Flags

    • Vehicle Theft/Fire Claims

    • Vehicle Accidents Involving Injuries

The instructor, Cliff Crosby has been involved in the insurance industry for 22 years. Twenty of those years have been spent in the Special Investigations Unit (SIU) He has been a claims adjuster, claim manager, SIU Special Investigator, and now Director of SIU. Cliff graduated from the University of Mount Olive with a Bachelor of Science Degree in Criminal Justice Administration. He also holds the designation of Certified Insurance Fraud Investigator (CIFI) and Fraud Claims Law Specialist (FCLS).