Investigations for insurers

Insurance investigations: establishing the facts behind the claims

Insurers, mutuals, brokers and claims inspectors: our CNAPS-licensed detectives document the reality behind claims and declarations: fraud, sick leave, untraceable beneficiaries, with court-ready reports.

Insurance fraud is not a victimless offence: every staged or inflated claim ends up in the premiums paid by every policyholder. The French market has organised its response, notably around ALFA, the French insurance anti-fraud agency, and claims departments increasingly outsource sensitive verifications to licensed investigators. Our agency at 10 rue de la Paix covers the whole Paris region, with national reach through the Prometheus Group. This page explains what we investigate for insurers, how an assignment unfolds, what a report can legally achieve, and what it costs.

Why do insurers instruct a private detective?

Because a claims handler can neither verify facts in the field nor observe a policyholder: a CNAPS-licensed detective can, lawfully, from public space, cross-checking open sources and producing a dated, detailed report that stands up in negotiation, contradictory expert proceedings or litigation.

An inspector’s doubt remains an intuition until it is documented. Our job is to turn that doubt into facts: either the declaration is corroborated, and the claim can be settled with confidence, or the inconsistencies are established and the insurer decides what follows with full knowledge. Either way, the investigation secures the decision.

We work under a written mandate, directly with the claims handler, fraud inspector or the company’s counsel, and scale the investigation to the stakes: a few days of open-source verification, or a full observation operation over several weeks.

What assignments do we handle for insurance companies?

Verification of suspicious claims (theft, fire, water damage, accidents), checks on declared sick leave and disability, counter-investigation of accident circumstances, life-insurance beneficiary tracing and financial enquiries for recovery actions: four families of assignments, one evidentiary standard.

In practice, our mandates break down as follows:

  • Claims fraud: inconsistent theft declarations, fires with doubtful circumstances, serial claims, pre-existing damage presented as new
  • Sick leave and disability: activity incompatible with the declared incapacity, undeclared work during leave, see also our sick-leave fraud page for employers
  • Financial enquiries and beneficiary tracing: dormant life-insurance policies, untraceable heirs, solvency of a liable third party
  • Liability claims: inflated losses, false certificates, accommodating witnesses

How does an assignment for an insurer unfold?

A written scoping with the claims handler (the cover at stake, the precise question to settle, the budget), open-source verification, then field observation where needed; delivery as a factual, time-stamped report with exhibits, within a deadline agreed from the outset.

Every assignment follows the same path: a precise insurance question (is the insured carrying on an activity incompatible with his disability? is the “stolen” vehicle still on the road?), a defined scope, means proportionate to the stakes, and a usable report: chronology, findings, time-stamped photographs taken from public space, cited sources.

Our investigators deploy across the Paris region within 48 hours, faster in genuine urgency. For companies with regular volumes we appoint a single point of contact and apply a degressive rate card.

Confidentiality runs both ways: the file you entrust to us is covered by professional secrecy, our exchanges can transit through your counsel when litigation is anticipated, and the raw material, photographs, notes, recordings of findings, is archived securely then destroyed at the end of the retention period agreed in the mandate. You keep a single, complete, signed report: the document you can actually use.

Can the report actually be used against fraud?

Yes. An intentional false declaration voids the policy (art. L113-8 of the French Insurance Code) and proven fraud amounts to criminal deception (art. 313-1 of the French Criminal Code). A fair report, public-space observation, open sources, is admissible before both civil and criminal courts.

French case law admits private investigators’ reports provided the evidence was obtained fairly and any interference with privacy remains proportionate to the aim pursued, which is precisely our working framework. No intrusion into the home, no unfair stratagem, no unlawful interception: findings, dates, facts.

Depending on the case, the report serves to: invoke the nullity of the policy or forfeiture of cover, bring the indemnity back to the reality of the loss, support a criminal complaint for deception, or feed the recovery action against a third party, hand in hand with your counsel.

Line of businessTypical fraud patternWhat the investigation establishes
MotorStaged theft, arranged accident, doctored mileageVehicle located, actual use, inconsistencies in the circumstances
PropertyInflated claim, pre-existing damage, double recoveryPrior condition, lifestyle, serial claims across insurers
Health / disabilitySick leave with a parallel activity, exaggerated disabilityActual activity observed in public space, documented regularity
Life insuranceUntraceable beneficiary, inheritance captureBeneficiary located and identified, succession chain reconstructed
LiabilityInflated loss, false certificatesReality of the damage, accommodating witnesses exposed

What do these files look like in practice?

Three anonymised examples: a “stolen” saloon found back on the road under different plates; a declared total disability contradicted by three weeks of documented activity as a sports coach; a life-insurance beneficiary traced abroad after the family chain was reconstructed.

The stolen car still driving. An insurer doubts a theft declaration for a recent saloon, the same policyholder’s third claim in a few years. Open-source checks spot a sale listing with identical characteristics; observation confirms the vehicle is still on the road, under different plates, within the family circle. Indemnity refused, complaint filed.

The variable-geometry disability. A policyholder draws a disability annuity that, he says, prevents any activity. Three weeks of spot observations establish outdoor training sessions he runs, also published on his own social feeds. The annuity is revised after contradictory expert appraisal, our report in support.

The untraceable beneficiary. A life policy lies dormant, the designated beneficiary having left France long ago. Civil-status reconstruction and open-source research locate her abroad; the capital is paid out and the insurer discharges its legal obligations.

Which mistakes weaken a fraud file?

Waiting too long before verifying, confronting the insured before having facts, collecting “evidence” yourself outside the legal framework, or building a refusal of cover on intuition: so many reflexes that hand the other side grounds for challenge. Chronology and fairness make a file solid.

  • Do not confront too early: an alerted policyholder adapts his behaviour and the observation window closes
  • Do not collect outside the framework: a capture obtained through a fake profile or an intrusion contaminates the whole file
  • Date the doubt: the closer the verification is to the declaration, the more probative the comparison
  • Match the question and the means: a mere documentary inconsistency does not justify three weeks of surveillance, proportionality is a condition of admissibility

Why entrust these investigations to Prometheus?

A CNAPS-licensed agency at 10 rue de la Paix (Paris 2nd), member of the WAD, experienced in insurance files: absolute professional secrecy, fair methods, reports calibrated for expert proceedings and litigation, deadlines kept and transparent billing from €85/hour (excl. VAT).

Our investigators know the constraints of your business: limitation periods, contradictory expert appraisal, and a policyholder relationship to preserve for as long as fraud is not established. They also know how to remain invisible, an exposed investigation is a weakened file. Our OSINT unit completes the fieldwork: public profiles, online listings, commercial activity hidden behind pseudonyms.

How much does it cost?

Our assignments start at €85/hour (excl. VAT) (full day €850, volume discounts). Every case gets a free written quote before any commitment, no hidden fees.

An open-source verification costs a few hundred euros; a multi-day observation operation, a few thousand, always announced before the first euro is spent. Administrative enquiries start from €350 (excl. VAT).

See the full price list.

Frequently asked questions

Is a written mandate required to investigate a policyholder?
Yes. Every assignment is contracted with the insurer, the mutual or its counsel: precise object, cover at stake, scope and budget. This mandate, consistent with our CNAPS licence, secures both the admissibility of the report and everyone’s liability.
Can the insured find out he is being checked?
No. Observations are conducted discreetly from public space and open-source checks leave no visible trace. Discretion protects both the file and the contractual relationship should the doubt be lifted.
What if the investigation clears the insured?
A frequent and useful outcome: the report corroborates the declaration, the claim can be settled without reservation and the insurer avoids pointless litigation. A serious investigation serves the truth, not a theory.
Are your reports accepted by the courts?
Yes, provided the evidence is fair and proportionate, our working standard. French civil and criminal courts admit reports from CNAPS-licensed investigators; they are regularly decisive on policy nullity or forfeiture of cover.
Do you offer terms for regular instructing parties?
Yes. Beyond 20 hours the hourly rate drops from €85 to €80 (excl. VAT), then €75 beyond 30 hours and €70 beyond 40. A single point of contact and a consistent report format are set up for companies sending a flow of files.

A doubt, a situation to clarify?

First consultation free and confidential. We reply 7 days a week.