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Home Insurance - Counter Fraud Investigator

Job description


Job Title: Home Claims Counter Fraud Investigator
Location: UK-East Midlands-Nottingham
Hybrid - 1 day per week in the office
£26 - 28k plus great benefits

Overview:

Responsibilities:

  • Screening incoming Home referrals against known fraud indicators and other risk factors, identifying cases where investigation is required.
  • 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.
  • Telephonic interviewing of claimants utilising specialist cognitive interviewing and conversation management techniques in order to further determine risk and separate honesty from inconsistency.
  • Pursuing follow up inquiries with external parties including regulatory and licensing authorities, other insurers and law agencies.
  • Providing focused instructions to, and subsequently liaising with, specialist investigative suppliers including field investigators, engineers and forensic specialists.
  • Validating documents.
  • Assessing the completed 'evidential picture' in order to determine the correct outcome for the claim.
  • Managing claims caseload, in accordance with the Markerstudy claims philosophy, claims handling procedures and service levels.
  • Adhering to agreed personal authority limits, referring to line manager for authorisation where activity exceeds such limits.
  • Ensuring compliance with all regulatory requirements (including "treating customers fairly" principles).
  • Responding promptly and pro-actively to incoming telephone calls and correspondence by use of telephone, e-mail and letter.
  • Maintaining good file discipline and accurate reserves, together with an effective diary system which ensures that cases are reviewed on a regular basis.
  • Developing and maintaining effective relationships with colleagues and business partners.
  • Pro-actively managing personal training and development requirements.
  • Undertaking general claims tasks, as required
  • To adhere to Company processes with regard to FCA compliance and Treating Customers Fairly;
  • To ensure that DPA, FCA & TCF and other regulatory requirements are met.

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