Remote Insurance Claims Investigator

Placements24; Queenstown; Ibrido; NZD 45.000 - 58.000; Tempo pieno

Vantaggi offerti da questo lavoro

Fully remote work

Flexible schedule

Descrizione del lavoro

Placements24 is seeking a highly motivated Remote Insurance Claims Investigator to join a leading national insurer. This fully remote role requires handling claims from or related to the Queenstown area in South Africa, with strong analytical and investigative skills.

Responsibilities include gathering evidence, interviewing parties, assessing liability, and detecting fraud. You will work independently in a remote setting, maintain records, and ensure regulatory compliance while collaborating

Competenze

• Matric certificate required; degree in Criminal Justice, Law, or related field advantageous.
• Minimum 4 years in insurance claims investigation, fraud detection, or related role.
• Proven ability to conduct detailed investigations and write reports.
• Strong understanding of insurance principles, policy wordings, and claim types.

Mansioni

• Conduct comprehensive investigations into insurance claims (property, casualty, motor).
• Gather and analyze evidence including policy documents, witness statements, police reports, and photos.
• Interview claimants, witnesses, and others remotely via phone/video.
• Assess damages and liability; identify fraud or misrepresentation.
• Prepare detailed investigation reports with findings and recommendations.
• Maintain confidential records of investigative activities and timelines.
• Collaborate with claims adjusters, legal counsel, and internal teams.
• Ensure compliance with insurance regulations and company policies.
• Manage caseload and meet deadlines in a remote setting.

Conoscenze

Analytical skills

Interviewing

Remote work

Report writing

Integrity

Formazione

Matric certificate (Grade 12)

Criminal Justice degree (advantageous)

Strumenti

Case management software

Office software

Descrizione del lavoro

About the Role

Our client, a leading national insurer, is seeking a highly motivated and meticulous Remote Insurance Claims Investigator to join their expanding team. This is a fully remote position, offering the flexibility to work from anywhere within South Africa while focusing on claims originating from or related to the Queenstown, Eastern Cape area. You will be responsible for conducting thorough investigations into complex insurance claims to determine the validity, extent of liability, and potential for fraud. This role requires exceptional analytical skills, discretion, and the ability to gather and interpret evidence effectively. The ideal candidate is a self-starter who thrives in an independent work environment and possesses a strong understanding of insurance principles and investigative techniques.

Key Responsibilities

• Conduct comprehensive investigations into various types of insurance claims (e.g., property, casualty, motor).
• Gather and analyze evidence, including policy documents, witness statements, police reports, and photographic evidence.
• Conduct interviews with claimants, witnesses, and other relevant parties via phone, video conference, or other remote methods.
• Assess the extent of damages and liability associated with claims.
• Identify and investigate potential instances of fraud, misrepresentation, or non-disclosure.
• Prepare detailed investigation reports with clear findings and recommendations.
• Maintain accurate and confidential records of all investigative activities.
• Collaborate with claims adjusters, legal counsel, and other internal departments as needed.
• Ensure compliance with all relevant insurance regulations and company policies.
• Manage a caseload of investigations, prioritizing tasks and meeting deadlines in a remote setting.

Requirements

• A Matriculation certificate (Grade 12) is required; a relevant diploma or degree in Criminal Justice, Law, or a related field is advantageous.
• Minimum of 4 years of experience in insurance claims investigation, fraud detection, or a related investigative role.
• Proven experience in conducting detailed investigations and report writing.
• Strong understanding of insurance principles, policy wordings, and common claim types.
• Excellent analytical, critical thinking, and problem-solving skills.
• Exceptional interviewing and communication skills, with the ability to build rapport remotely.
• High level of integrity, discretion, and professionalism.
• Proficiency in using digital communication tools, case management systems, and standard office software.
• Ability to work autonomously and manage time effectively in a fully remote environment.
• Reside within South Africa and have reliable internet connectivity.

Benefits

This position offers a competitive salary and a comprehensive benefits package including medical aid and a retirement fund. The primary benefit is the fully remote nature of the work, providing unparalleled flexibility and work-life balance. Our client is committed to employee development, offering opportunities for specialized training in investigation techniques and fraud prevention. You will join a supportive virtual team culture focused on integrity and efficiency, contributing to the protection of the company's assets and the fair treatment of policyholders in the Eastern Cape region.