Fraud Investigator
First Central Insurance & Technology Group
- Haywards Heath, West Sussex
- £29,000-34,000 per year
- Permanent
- Full-time
- Carry out thorough investigations and gather evidence on suspected fraudulent claims for personal injury, vehicle damage and credit hire
- Conduct telephone interviews with customers as well as engaging external suppliers including accident investigators, motor engineers and panel solicitors
- Assessing evidence including intelligence, Police reports, medical records and engineering evidence to identify inconsistencies and determine the outcome
- Identifying 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.
- 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.
- Carry out duties, activities and tasks as directed within the Claims and Fraud pillar
- Strong experience of handling fraudulent customer, third party damage and personal injury claims
- Proven track record in investigating both opportunistic and organised 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) an the regulatory framework relating to general insurance
- Strong communication skills, both verbal and written and negotiation and influencing skills
- Good time management and organisation skills with the ability to prioritise 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
- Adopts a proactive approach to their workload
- Identifies and communicates potential process and efficiency improvements
- Embrace, embed and incorporate 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.