The purpose of an insurance fraud investigation is to gather evidence sufficient to establish that a suspected fraudulent claim is legitimate or is a case of attempted fraud. If the facts reveal the claim is legitimate, the fraud investigation stops and the claim is paid quickly and fairly. If the facts support the suspicion of fraud, further investigation is required to gather evidence that convinces the insurer that a preponderance of available evidence reveals a fraud is being attempted. The insurer can, with such evidence, successfully deny the claim and refuse to pay.
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