Senior Insurance Claims Investigator - Fraud & Forensics

Placements24; Willows (CA); On-site; USD 21,000 - 37,000; Full time

Benefits offered by this job

Medical aid

Provident fund

Professional development

Job summary

Placements24 is seeking a Senior Claims Investigator for our client, a reputable insurance company, in Welkom, Free State. The role focuses on in-depth investigations into complex and potentially fraudulent insurance claims, ensuring integrity of the claims process and protecting assets.

The ideal candidate has strong interviewing and analytical skills, experience with policy terms and fraud indicators, and can liaise with law enforcement and legal counsel.

Qualifications

• A relevant tertiary qualification in policing, criminology, law, or a related field.
• Minimum 6 years' experience in insurance claims investigation, fraud detection, or law enforcement.
• Proven ability to conduct interviews, collect evidence, and write detailed reports.
• Strong understanding of insurance policies, claims processes, and fraud typologies.
• High integrity, discretion, and ability to manage multiple cases independently.

Responsibilities

• Plan, organize, and conduct thorough investigations into suspicious and complex insurance claims.
• Gather and analyze evidence, including interviewing witnesses, claimants, and involved parties.
• Document all investigative findings meticulously in detailed reports.
• Identify potential fraud indicators and apply appropriate investigation methodologies.
• Liaise with internal departments, law enforcement agencies, and legal counsel as necessary.
• Assess the validity of claims based on investigation findings and policy terms.
• Provide expert testimony in legal proceedings when required.
• Maintain confidentiality and adhere to strict ethical and legal standards.
• Recommend appropriate actions based on investigation outcomes, such as claim denial or prosecution referral.
• Stay current with fraud trends, investigative techniques, and relevant legislation.

Skills

Interviewing

Evidence collection

Report writing

Analytical thinking

Travel ready

Education

Diploma in Policing, Criminology, or Law

Tools

Microsoft Office Suite

Investigation management software

Job description

Placements24 is seeking a Senior Claims Investigator for our client, a reputable insurance company, in Welkom, Free State. The role focuses on in-depth investigations into complex and potentially fraudulent insurance claims, ensuring integrity of the claims process and protecting assets.

The ideal candidate has strong interviewing and analytical skills, experience with policy terms and fraud indicators, and can liaise with law enforcement and legal counsel.