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Insurance Fraud Investigator
2 months ago
We are seeking a highly skilled and experienced 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- Investigate suspected fraudulent claims, including personal injury, vehicle damage, and credit hire
- Conduct telephone interviews with customers and engage with external suppliers, including accident investigators, motor engineers, and panel solicitors
- 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 regarding 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, including 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
At First Central Insurance Management Ltd, we offer a dynamic and supportive work environment, with opportunities for professional growth and development. We are committed to providing our employees with the tools and resources they need to succeed in their roles.
We are an equal opportunities employer and welcome applications from diverse candidates. If you are a motivated and experienced Fraud Investigator looking for a new challenge, please submit your application.