Claims Fraud Investigator

Claims Fraud Investigator - Motor Insurance

Salary: Competitive

Hours: 35 hours per week, Monday-Friday

Locations: Chesterfield, Manchester, Nottingham, and Tunbridge Wells.

Hybrid: 3 days remote, 2 days office-based

Overview

My client is a leading and expanding insurance group looking to recruit experienced Claims Fraud Investigators to join their dynamic and forward-thinking teams.

The main purpose of this role is to proactively screen and investigate a portfolio of suspect motor accident claims.

As a Fraud Investigator, you will be responsible for screening incoming claims referrals against known fraud indicators and other risk factors and identifying cases where an investigation is required.

Responsibilities

• Screening incoming claims referrals and identifying cases that require further investigation
• Managing fraud rings and linked claim investigation, adhering to internal and IFB protocols.
• Utilising a variety of desktop tools (CUE, MIAFTR, etc.) as well as various internet checks and databases to assist with claimant profiling and to determine the direction of the investigation.
• Utilise conversation management techniques to further determine risk and separate honesty from inconsistency when dealing with all claimants and their representatives.
• Pursuing follow-up inquiries with external parties including regulatory and licensing authorities, other insurers, and law agencies.
• Providing focused instructions and liaising with specialist investigative suppliers including field investigators, engineers, and forensic specialists.
• Validating documents.
• Adhering to agreed personal authority limits, referring to line manager for authorisation where activity exceeds such limits.
• Responding promptly and proactively to incoming telephone calls and correspondence by use of telephone, e-mail, and letter.
• Maintaining good file discipline and accurate reserves, together with an effective diary system ensuring that cases are reviewed on a regular basis.
• Provide detailed feedback to the Claims Departments on claims that do NOT need investigation to assist with referral quality.
• Undertaking general claims tasks, as required
• To adhere to Company processes with regard to FCA compliance, DPA, and Treating Customers Fairly, ensuring strict compliance in all these areas.

Skills Required

• The ability to assess the evolving 'evidential picture' of a claim to drive a proactive investigation and determine the correct outcome.
• Bodily injury claims handling experience
• Investigation of suspect fraudulent RTA/bodily injury claims.

Benefits

• 25 days annual leave + bank holidays!
• 5% pension contribution scheme
• Healthcare benefits
• Life assurance
• Discounts on over 250 big retail brands