Fraud Investigator
2 weeks ago
We're First Central Insurance & Technology Group, an innovative, market-leading insurance company that relies on data to drive our success.
What we're looking for:
- Counter Fraud Team Member: We're seeking a Fraud Investigator to join our Counter Fraud Services team in Salford Quays, Manchester.
Responsibilities:
- Conduct thorough investigations and gather evidence on suspected fraudulent claims for personal injury, vehicle damage and credit hire.
- Carry out telephone interviews with customers and engage external suppliers to identify inconsistencies and determine the outcome.
- Assess evidence, including intelligence, Police reports, medical records, and engineering evidence.
- 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 KPI's and targets.
- Ensure compliance with Company financial crime procedures and related policies.
- Ensure compliance with TCF principles when liaising with customers.
- 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.
- Carry out duties, activities, and tasks as directed within the Claims and Fraud pillar.
Requirements:
- Strong experience of handling fraudulent customer, third-party damage, and personal injury claims.
- Proven track record in investigating both opportunistic and organised motor fraud.
- 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.
- 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.
- Computer literate, to include Word, Excel, PowerPoint, and the internet.
- Passionate about reducing the business exposure to fraud risk.
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