Fraud Investigator
7 days ago
We are seeking a highly skilled Fraud Investigator to join our Counter Fraud Services team at First Central Insurance Management Ltd. As a Fraud Investigator, you will play a critical role in protecting our business and customers from the impact of fraud.
Key Responsibilities- Conduct thorough investigations and gather evidence on suspected fraudulent claims for personal injury, vehicle damage, and credit hire.
- Assess evidence, including intelligence, Police reports, medical records, and engineering evidence, to identify inconsistencies and determine the outcome.
- Identify 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 KPIs 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.
- Strong experience of handling fraudulent customer, third-party damage, and personal injury claims.
- Proven track record in investigating both opportunistic and organized 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) and the regulatory framework relating to general insurance.
- Strong communication skills, both verbal and written, and negotiation and influencing skills.
- Good time management and organization skills with the ability to prioritize work.
- Analytical and problem-solving skills, with the ability to adopt a logical approach to resolving problems.
- Excellent customer service skills.
- Computer literate, to include Word, Excel, PowerPoint, and the internet.
- Self-motivated and enthusiastic.
- Consistently demonstrates a positive attitude.
- Can receive and give constructive feedback.
- Adept at adopting a proactive approach to your workload.
- Identifies and communicates potential process and efficiency improvements.
- Embraces, embeds, and incorporates the Company values.
- Passionate about reducing the business exposure to fraud risk.
- Emphasis on attention to detail and accuracy.
- Able to work on own initiative and as part of a team.
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