Claims Fraud Investigator

**Claims Fraud Investigator - Motor Insurance**

**Hours**:35 hours per week, Monday-Friday

**Salary**: Competitive

**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.
- 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