Fraud Investigator - Insurance Claims

Placements24; Vereeniging; On-site; ZAR 420,000 - 660,000; Full time

Benefits offered by this job

Competitive salary

Incentives based on performance

Medical + retirement benefits

Fraud investigation training

Roles safeguarding assets in Gauteng

Job summary

Placements24 seeks a sharp Fraud Investigator for its client in Vereeniging, Gauteng. You will join the Special Investigations Unit to detect, investigate, and prevent fraudulent insurance claims, gather evidence, and build strong cases for potential legal action.

With 3+ years in insurance fraud or related fields, you will analyze complex data, interview stakeholders, and collaborate with law enforcement. The role emphasizes confidentiality, integrity, and ongoing fraud training, in a

Qualifications

• Strong interviewing, interrogation and evidence-gathering abilities.
• Excellent analytical and critical thinking capabilities.
• Proficiency in data analysis and formal report writing.
• Discretion and integrity with ethical conduct.

Responsibilities

• Investigate suspicious insurance claims across lines of business to detect and prevent fraud.
• Analyze claim files, supporting documents, and databases for red flags.
• Conduct interviews with claimants, witnesses, and other parties.
• Gather and document evidence for admissibility in proceedings if needed.
• Liaise with law enforcement, counsel, and stakeholders as required.
• Prepare detailed investigation reports with findings and recommendations.
• Develop and implement proactive measures to prevent insurance fraud.
• Stay updated on fraud schemes, trends and investigation techniques.
• Maintain confidentiality and adhere to ethical standards.

Skills

Interviewing skills

Analytical thinking

Data analysis

Report writing

Communication skills

Education

Criminology / Law related field

Job description

About the Role

Our client, a leading insurer, is seeking a sharp and diligent Fraud Investigator to join their dedicated Special Investigations Unit (SIU) in Vereeniging, Gauteng. This role is critical in protecting the company and its policyholders from financial losses due to fraudulent insurance claims. The ideal candidate will possess a keen eye for detail, strong analytical skills, and the ability to conduct thorough investigations, gather evidence, and build compelling cases. This position offers a challenging and rewarding career in Vereeniging, contributing to the integrity of the insurance market in Gauteng.

Key Responsibilities

• Investigate suspicious insurance claims across various lines of business to detect and prevent fraud.
• Analyze claim files, supporting documents, and databases to identify red flags and indicators of fraudulent activity.
• Conduct interviews with claimants, witnesses, and other parties involved in claims.
• Gather and document evidence, ensuring its admissibility in legal proceedings if necessary.
• Liaise with law enforcement agencies, legal counsel, and other stakeholders as required.
• Prepare detailed investigation reports, outlining findings, evidence, and recommendations.
• Develop and implement proactive measures to prevent insurance fraud.
• Stay informed about current fraud schemes, trends, and investigation techniques.
• Maintain confidentiality and adhere to ethical standards throughout all investigations.
• Contribute to training initiatives aimed at raising awareness of fraud detection within the organization.

Requirements

• A minimum of 3 years of experience in insurance fraud investigation, law enforcement, or a related investigative field.
• Strong understanding of insurance principles and claims processes.
• Excellent interviewing, interrogation, and evidence-gathering skills.
• Exceptional analytical and critical thinking abilities.
• Proficiency in data analysis and report writing.
• Discretion and integrity, with a strong commitment to ethical conduct.
• Ability to work independently and manage caseloads effectively in Vereeniging.
• Good communication and interpersonal skills.
• A relevant qualification in Criminology, Law, or a related field is advantageous.

Benefits

• Competitive salary commensurate with experience.
• Potential for performance-based incentives.
• Comprehensive medical and retirement benefits.
• Opportunities for specialized training in fraud investigation techniques.
• A vital role in safeguarding the company's assets in Gauteng.