Motor Claims Crime Prevention Consultant
3 months ago
LV=GI have a fantastic opportunity for a Motor Claims Crime Prevention Consultant to join our family of accomplished people in the Claims Crime Prevention Teams. This role will be working from the Leeds, Ipswich or Bournemouth offices with the opportunity to work from home with 2 - 16 days per month working with your team in the office. We adopt a flexible working environment with a focus on learning and development.
LV= General Insurance is a large, multi-award-winning insurance company, with nearly 3 million customers and aspirations for future growth.
**Role Purpose**:
To prevent, investigate and detect insurance claims fraud through the proactive management case portfolio’s, providing business referral support and working with external bodies such as the Insurance Fraud Bureau and other law enforcement agencies.
**Key Accountabilities**
Responsibility for the decision making in respect of the retention of referrals from internal and external sources to the Claims Crime Prevention Teams, returning genuine claims urgently with constructive feedback.
To compile intelligence searches and more advanced ad hoc searchers as required to aide decision whether to retain or return claim
To engage with other departments support relationships and provide technical support
Ability to carry out appropriate Intel searches to ascertain is the claim is genuine or potentially fraudulent. This involves working across all systems and databases and evaluation of this data.
To have a good understanding of the different types of fraud scenarios and determining appropriate investigations to resolve suspicions of fraudulent activity
To effectively manage own within individual authority or on referral where applicable, implementing a wide range of relevant investigative techniques including instruction of suppliers to maximise the identification and repudiation of fraud while minimising any adverse impact upon customer experience, financial spend and company reputation.
Where a claim is deemed potentially fraudulent to capture and highlight relevant concerns and record this information accurately.
To identify and manage potential linked and organised cases, as well as claims farming (KYO) with referral to senior where appropriate
To identify and highlight specific fraud trends or companies to senior level
To be responsible for complying with all internal, regulatory and statutory standards and controls, so that the requirements of the Group and regulatory bodies are met.
Liaise with law enforcement and industry bodies.
Negotiate effectively with Policyholders & Third Parties to conclude settlement if appropriate
To manage litigation and ensure cases are progressed in a effective, timely and cost effective manner with referral to mentor or senior
To manage all complaints and to be responsible for maintaining contact with our customer through the complaint procedure, including keeping the complaints database up to date
To manage their own self development and contribute to their 1-2-1’s, team discussions, and continuous improvement programmes
To provide constructive feedback on supplier performance and raise and issues as appropriate
Ability to come up with practical solutions to problems and suggest new ways of working
Ability to interpret I2 charts
Ability to prepare witness statements and attend court as required
**Knowledge, skills, qualifications and experience**
Level 2 Role Accountabilities
To demonstrate a positive and proactive approach to the customer at all times during investigation keeping in line with TCF guidelines
To understand and adherence to the Data Protection Act
To be aware of and be able to demonstrate an understanding of claims and underwriting processes used across LV= Operations
To have a good understanding of principles of insurance, money laundering and POCA
To have a good understanding of personal injury claims, the MOJ process and required actions
To have a detailed understanding of investigation principles
To have a good knowledge of basic credit hire principles and fee structure
To demonstrate good communication skills both over the telephone and face to face, at all levels
To have a good understanding of insurance case law relating to fraud
Good knowledge of Paid Away and SARS
The ability to liaise with suppliers and law enforcement agencies confidently and proactively; and within agreed cost ratios
Ability to identify potential leakage on a case by case basis and provide suggested recovery including taking action to recover losses
Knowledge of basic Linked and Organised fraud and investigation techniques
Knowledge of basic credit hire principles and fee structure
To have a detailed understanding of investigation principles
To have a good understanding of insurance case law relating to fraud
**Why Work for Us?**:
Life at LV=GI
We’re not your average insurance company, in fact we strive to be different. You won’t find strict dress codes, jargon filled
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