Insurers, self-insurers, scheme agents and legal teams brief ProFact when suspicious claims require disciplined factual inquiry. Insurance fraud investigation at ProFact combines desktop intelligence, lawful field surveillance and structured reporting under senior investigator oversight, with evidence gathered for claims review, SIU referral, denial decisions and downstream recovery action.
Fraud work is methodical, not theatrical. ProFact approaches suspicious claims with the same evidentiary discipline as any other matter: building the picture, testing the version of events, and preserving the file for downstream prosecution, denial or recovery.
ProFact is regularly instructed on suspicious general insurance, CTP, liability and property claims across Australia. Our investigators understand how claim context, referral objectives and SIU workflows shape lawful scope, field deployment and the reporting claims handlers need.
Insurance fraud files often require both field observation and structured desktop research. ProFact holds NSW Security Master Licence #000111294 and deploys licensed private investigators who gather contemporaneous evidence lawfully, whether the brief is a short lifestyle check or sustained activity monitoring on an organised ring.
Findings are prepared for decision-makers, not advocacy. ProFact compiles fraud assessment reports, activity logs, network documentation and investigator statements in formats suited to claims panels, SIU review, solicitor file preparation or referral to regulators and prosecutors.
ProFact conducts insurance fraud investigations for insurers, self-insurers, scheme agents and legal teams nationwide. Whether a file involves a single suspicious claim, exaggerated injury reporting or an organised network of related claimants, each instruction is scoped by a senior investigator to the evidence types, locations and reporting objectives that matter. Work may combine desktop OSINT, lawful surveillance, association mapping and factual inquiry, with reporting structured for claims review, denial, recovery or referral.
Targeted factual inquiry on individual claims where reported injury, loss, incapacity or circumstances appear inconsistent with file history, treating records or intelligence received. ProFact reviews the claim at intake, identifies what must be established lawfully, and deploys desktop research or field surveillance proportionate to the referral rather than generic observation without purpose.
Investigation of multiple related claimants, staged accident allegations, shared service providers or recurring claim patterns that may indicate organised insurance fraud. ProFact maps associations through desktop intelligence, cross-claim review and coordinated field work, documenting networks and patterns in a form suited to SIU escalation or joint insurer action.
Lawful verification of whether a claimant's observed activity, employment, social conduct or asset signals align with reported restrictions, stated loss or claimed incapacity. Field surveillance and factual inquiry can help claims handlers assess exaggeration, undeclared work, concurrent benefits or lifestyle inconsistencies relevant to claim integrity.
Insurance fraud investigations across CTP and motor injury files, public and products liability claims, property and contents loss matters, and income protection or disability exaggeration. ProFact scopes work to the claim type, whether the central question is injury severity, loss verification, incident circumstances or claimant identity and association.
Many fraud files benefit from desktop and OSINT investigation before or alongside private surveillance. ProFact coordinates both under senior investigator oversight so public online material, records intelligence and field observations inform one coherent fraud assessment rather than disconnected work products.
Structured reporting for insurer special investigation units, including fraud assessment summaries, chronologies, network documentation and evidence packages suited to internal denial committees, external legal review or referral to regulators and prosecutors. Where proceedings are anticipated, ProFact can also scope court and legal support under separate written terms.
Insurance fraud investigations often turn on whether observed activity aligns with what is claimed on the file. When reported incapacity, property loss, injury severity or lifestyle restrictions need testing, licensed private investigators can lawfully observe subjects in public or other permitted settings and document findings with contemporaneous notes and video.
Before field work begins, desktop and OSINT investigations can establish a baseline on social media activity, business interests, public records and online associations. That intelligence helps senior investigators plan surveillance proportionately and avoid unfocused field deployment on claims where public material already answers key questions.
ProFact does not simply collect footage or screenshots. Desktop findings, surveillance chronologies and investigator statements are compiled into a coherent fraud assessment suited to claims handlers, SIU teams and legal advisers managing denial, recovery or referral decisions.
ProFact is briefed on suspicious and organised claims where insurers, self-insurers, scheme agents or legal teams need impartial factual evidence on claim integrity, claimant activity or network behaviour. Each instruction is scoped by a senior investigator, conducted lawfully under agreed written terms, and reported in a form suited to claims review, denial or referral.
Investigation of suspicious CTP and motor injury claims where reported incapacity, treatment patterns or accident circumstances require verification. ProFact can combine desktop research and lawful surveillance to test whether observed activity aligns with stated injury severity or restrictions.
Factual inquiry on liability claims where incident circumstances, claimant conduct or third-party involvement may not align with the version of events on file. Field observation and witness inquiry can help establish what occurred and whether claim presentation is supported by evidence.
Investigation of suspicious property, contents or theft claims where loss severity, ownership, occupancy or claimant lifestyle may require verification. Desktop intelligence and field inquiry can help assess whether reported loss or damage is consistent with observed circumstances.
Claims where reported incapacity, treatment compliance or return-to-work status appear inconsistent with observed employment, social activity or lifestyle. ProFact gathers lawful evidence so decision-makers can assess exaggeration relative to policy terms and medical certification.
Instructions alleging staged collisions, fabricated incidents or inflated injury reporting. ProFact reviews claim history, association signals and field intelligence to help SIU teams assess whether multiple claimants, providers or locations form a pattern requiring escalation.
Network investigations where recurring claimants, shared addresses, common treating providers or cross-policy activity suggest organised fraud. ProFact documents associations and activity patterns in reporting suited to joint insurer review, denial strategy or external referral.
Where injury claim fraud sits within a workers compensation file rather than a general insurance policy, ProFact can scope related workers compensation investigation under the same senior investigator oversight, with reporting structured for the instructing claims environment.
Insurance fraud investigations follow a disciplined sequence so intelligence, field evidence and reporting remain coherent from first instruction through to referral or denial support.
Submit an insurance fraud briefA senior investigator reviews the claim file, referral objectives, locations of interest and what must be established lawfully before any desktop or field work begins.
Public online material, records intelligence and cross-claim signals are assessed to shape scope, identify associations and avoid unfocused surveillance deployment.
Licensed investigators deploy lawfully within agreed observation windows, gathering contemporaneous notes, video and factual material proportionate to the brief.
Desktop findings, surveillance chronologies and investigator observations are correlated into a coherent fraud assessment with documented chain of evidence.
Findings are delivered in formats suited to claims handlers, SIU teams and legal advisers managing denial, recovery or referral decisions.
Straight answers on insurance fraud investigations in Australia. For broader licensing topics, see our Australian private investigator FAQ.
An insurance fraud investigation is a lawful factual inquiry instructed to test whether a claim, claimant or network of claimants is presenting information that does not align with observed activity, records or claim history. ProFact gathers desktop intelligence, field surveillance where scope permits and structured reporting for insurers, self-insurers, scheme agents and legal advisers. Every brief is reviewed by a senior investigator before deployment.
ProFact is regularly briefed by insurers, self-insurers, scheme agents, corporate risk teams and legal representatives acting on their client's instructions. Each enquiry is reviewed at intake to confirm the instructing party can lawfully engage investigation services and that the proposed scope is appropriate to the claim file or SIU referral.
Surveillance can help establish what a claimant or subject is doing relative to reported injury, incapacity, loss or lifestyle restrictions. ProFact investigators document activity with contemporaneous notes and time-coded video where lawfully obtained, then report in a form suited to claims review, denial decisions or referral. See private surveillance investigation for broader field observation services and the instruction contexts on this page.
Common instructions include suspicious CTP and motor injury claims, liability and public liability matters, property and contents fraud, income protection and disability exaggeration, staged accident allegations and organised multiple-claimant patterns. ProFact also supports SIU teams with network mapping, cross-claim analysis and evidence packages suited to referral or recovery action. See claim types on this page for detail.
Fees depend on claim location, surveillance duration, desktop research depth, number of subjects, travel and reporting requirements. A targeted verification brief is scoped differently from sustained surveillance on an organised ring. ProFact provides a confidential scoping discussion and written quotation before deployment. Use our PI cost calculator for indicative guides, then submit your brief for a scoped quote.
Yes. Confidentiality is central to fraud investigation work. ProFact does not disclose client identity, brief details or investigation findings to third parties without your instruction or a valid legal requirement to do so. Reports are released only to instructed parties unless scope or law requires otherwise. For broader licensing topics, see our Australian private investigator FAQ.
Consultations are conducted by a senior investigator. We will scope the matter, confirm capability and provide written terms before any desktop research or field deployment begins.
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