Investigation Responsibilities
Investigation on potential fraud incidents and cases, including field investigation/site visits on suspected fraud cases related to motor, third-party property damage, bodily injury, liability, property damage, medical, workmen's compensation, and personal accident, as identified by claims handlers.
Collaborate with claims handlers, in-house assessors, external loss adjusters, repair shops, and other related service providers on fraud claims detection.
Collaborate with defense solicitors to provide deposition strategies and utilize law enforcement resources for assistance.
Maintain a close working relationship with local police and other law enforcement in the insurance sector, and network with industry members to stay informed about developments in the insurance and financial institutions.
Prepare relevant investigation reports in a timely manner.
Work closely with ISM-FIS and all relevant stakeholders on the utilization of the Fraud Investigation System, including collating and analyzing fraud claims data and industry trends.
Conduct objective, fair, thorough, unbiased, and timely investigations into allegations of insurance fraud by clients and monitor all suspicious activities daily to identify new fraud patterns.
Accountabilities
Identify, prevent, and reduce leakages due to insurance fraud.
Assist the FIU Manager, in-house assessors, external loss adjusters, including forensics and claims handlers in cases where fraud or criminality is suspected.
Manage multiple cases with confidence and accuracy while meeting targets and tight deadlines.
Liaise with authorities to gather information and evidence on fraudulent claims.
Review case circumstances through research, interviews, surveillance, and in-person inspections of sites and vehicles, and write reports on findings.
Check backgrounds of claimants, witnesses, and other relevant individuals before conducting investigations.
Discuss case circumstances with the FIU Manager and prepare reports, maintain records, and track evidence trails and interview statements.
Discuss market trends and modus operandi process enhancements with the FIU Manager to detect and deter potential fraudsters.
Perform any other tasks assigned by the FIU Manager.
Key Performance Indicators
Detection of fraudulent claims.
Closure of investigated cases.
Reduction of claims leakages due to claims fraud.
Compliance with company and regulatory guidelines.
Knowledge Requirements
Proficient in insurance procedures, regulations, and investigation methods; understanding of laws related to public and insurance funds is necessary.
Good knowledge of motor insurance and fraud investigations.
Proficient in computer skills (Word, Excel, PowerPoint).
Benefits
Hybrid workplace (depending on the nature of the role), training, medical, dental and vision coverage, birthday leave, insurance coverage, car and housing loan interest subsidy, long service award, company annual dinner, sports club.
Seniority LevelEntry level
Employment TypeFull-time
Job FunctionInformation Technology
IndustriesInsurance#J-18808-Ljbffr