Insurance Claims Investigator

Placements24; Roanoke (VA); Hybrid; USD 15,000 - 26,000; Full time

Benefits offered by this job

Competitive salary

Hybrid work

Medical aid

Retirement fund

Forensic training

Job summary

Placements24 in East London, Eastern Cape seeks an Insurance Claims Investigator to handle complex and potentially fraudulent claims. You will gather evidence, interview parties, assess liability and coverage, and prepare formal reports to support claims decisions.

The role emphasizes integrity, discretion, and strong analytics, with travel within the Eastern Cape and collaboration with legal counsel when needed. A hybrid work setup is offered.

Qualifications

• Proven experience in insurance claims investigation, fraud detection, or law enforcement investigation.
• In-depth knowledge of insurance principles, claims processes, and fraud investigation techniques.
• Strong analytical, critical thinking, and problem-solving abilities.
• Excellent interviewing, negotiation, and communication skills.
• Ability to maintain confidentiality and exercise discretion.
• A valid driver's license and willingness to travel within the Eastern Cape for investigations are essential.

Responsibilities

• Conduct thorough investigations into potentially fraudulent or complex insurance claims across various lines of business.
• Gather and analyze evidence, including accident reports, witness statements, policy documents, and financial records.
• Interview claimants, witnesses, and other relevant parties to obtain factual information.
• Assess liability, damages, and policy coverage in relation to the investigated claim.
• Prepare detailed, comprehensive investigation reports with clear findings and recommendations.
• Liaise with legal counsel, law enforcement, and other external parties as necessary during investigations.

Skills

Insurance claims investigation

Fraud detection

Analytical thinking

Interviewing skills

Negotiation

Communication skills

Confidentiality

Driver's license

Willingness to travel

Job description

About the Role

Our client is seeking a diligent and thorough Insurance Claims Investigator to join their dedicated team serving the Eastern Cape region, based in East London. In this role, you will be responsible for investigating suspicious or complex insurance claims to determine the validity, extent of liability, and potential for fraud. Your work will involve gathering evidence, interviewing relevant parties, and preparing detailed reports to support claims decisions. This position requires integrity, discretion, and strong analytical skills to uphold the company's commitment to fair claims handling and fraud prevention.

Key Responsibilities

• Conduct thorough investigations into potentially fraudulent or complex insurance claims across various lines of business.


• Gather and analyze evidence, including accident reports, witness statements, policy documents, and financial records.


• Interview claimants, witnesses, and other relevant parties to obtain factual information.


• Assess liability, damages, and policy coverage in relation to the investigated claim.


• Prepare detailed, comprehensive investigation reports with clear findings and recommendations.


• Liaise with legal counsel, law enforcement, and other external parties as necessary during investigations.

Requirements

• Proven experience in insurance claims investigation, fraud detection, or law enforcement investigation.


• In-depth knowledge of insurance principles, claims processes, and fraud investigation techniques.


• Strong analytical, critical thinking, and problem-solving abilities.


• Excellent interviewing, negotiation, and communication skills.


• Ability to maintain confidentiality and exercise discretion.


• A valid driver's license and willingness to travel within the Eastern Cape for investigations are essential.

Benefits

• Competitive salary with potential bonuses for successful fraud detection.


• Hybrid work arrangement offering flexibility.


• Comprehensive medical aid and retirement fund benefits.


• Opportunities for specialized training in forensic investigation and fraud prevention.


• A critical role in protecting the company from fraudulent claims and ensuring fair treatment of policyholders.