We are currently representing a very progressive and entrepreneurially led Insurance group who are looking for a Fraud Investigator to join a growing, innovative team, responsible for protecting the business and customers from the impact of fraud. You'll be investigating a caseload of suspected fraudulent claims, ranging from Low Velocity Impacts to Staged and Contrived collisions.
Key Responsibilities:
- Carry out thorough investigations and gather evidence on suspected fraudulent claims for personal injury, vehicle damage and credit hire
- Conduct telephone interviews with customers as well as engaging external suppliers including accident investigators, motor engineers and panel solicitors
- Assessing evidence including intelligence, Police reports, medical records and engineering evidence to identify inconsistencies and determine the outcome
- Identifying cases of potential Fundamental Dishonesty, private prosecutions, or professional enabler involvement
- Provide advice and support to business areas with regard to potential fraud risks.
- Process payments on claims files as required and in accordance with authorities.
- Ensure claim files are reserved accurately and reserves amended where required.
- Meet agreed fraud KPI's and targets.
- Ensure compliance with Company financial crime procedures and related policies.
- Submit Suspicious Activity Reports as necessary to the Company MLRO.
- Ensure compliance with TCF principles when liaising with customers.
- Build and maintain relationships both internally and externally.
- To be compliant with health and safety policies at all times.
- Ensure compliance with company and other relevant standards/ regulations at all times.
- Produce high quality written reports and advice for the business, to include recommendations.
- Any other reasonable duties as required.
- Carry out duties, activities and tasks as directed within the Claims and Fraud pillar
Experience & knowledge:
- Strong experience of handling fraudulent customer, third party damage and personal injury claims
- Proven track record in investigating both opportunistic and organised motor fraud
- Managing a caseload with adherence to SLAs
- Proven track record of stakeholder management
- Strong understanding of motor insurance fraud and the purpose of a Counter Fraud Team
- Strong understanding of the various indemnity levels and the subsequent impact that this may have on the claim/policy
- An understanding of Part 7 and Part 8 Proceedings
- Strong understanding of the litigation process and the impact that this has on the business both procedurally and economically
- Strong understanding of regulatory responsibilities (SMRC)
- Excellent knowledge of FCA requirements (including TCF) an the regulatory framework relating to general insurance
Applicants must be located and eligible to work in the UK without sponsorship. Please note, should feedback not be received within 28 days, unfortunately your application has been unsuccessful. In applying for this role, you may be registered on our database so we can contact you about suitable opportunities in future. Your data will be managed in accordance with our Privacy Policy, which can be found on our website. If you would like this job advertisement in an alternative format, please contact MERJE directly.