The key purpose of this role is to investigate, quantify, reserve and settle claims in the most effective way.  Undertake analysis of evidence/data, provide relevant and accurate information assisting in the detection and prevention of insurance fraud.

Reporting to:

Fraud Manager

Key Responsibilities:

Manage own portfolio of fraudulent/staged accident claims.
To identify a variety of motor claims including staged accidents, phantom passengers and non personal injuries claims where there are concerns of potentially fraudulent claims.
Compile reports/profiles on individuals and groups involved in suspected fraudulent activities.
Report regularly to management regarding area of concerns and areas where we may be vulnerable.
Prepare monthly reports on the number of potential claims detailing costs and savings made.
Inform underwriters of any fraudulent/contentious claims made by policyholders.
Act as a referral point when required by the department.
Ensure Divisional Director – Claims and Assistant Claims Manager are made aware of all contentious or serious personal injury cases as soon as possible.
Ensure targets/KPI’s are met or surpassed.
Work with the Claims management team to generally develop the operation.

Ad hoc or Additional:

The role may require the working of occasional weekends to assist with ad hoc projects
The above represents the key areas of responsibility within your role; however you may be required to cover additional duties as and when required.

Experience:

At least 7 years motor claims experience, preferably with some level of personal injury claims handling and a proven track record specialising in fraud.

Professional Qualifications:

Ideally will have CII qualification or will be considering progression towards it.

Skills/Personal Qualities:

Strong investigation and reporting skills, good organisation skills, ability to work under pressure and to deadlines, good communication skills including the ability to diffuse and resolve difficult situations, computer literacy and good key board skills, ability to make decisions where necessary or know when to refer, honesty, integrity, reputation, competence/capability and financial soundness as required by the FSA.