Insurance Claims Investigator

Placements24; Centurion; On-site; ZAR 320,000 - 460,000; Full time

Benefits offered by this job

Competitive salary

Overtime potential

Company vehicle

Travel allowance

Health benefits

Forensic training

Supportive work environment

Job summary

Placements24 in Centurion, Gauteng, is seeking an Insurance Claims Investigator to join our client’s team. The role involves conducting thorough investigations into potentially fraudulent insurance claims across various lines, gathering evidence, interviewing witnesses, and preparing detailed reports to support claims decisions.

The successful candidate will have at least 3 years of experience in claims investigation, strong analytical and interviewing skills, and a solid understanding of

Qualifications

• Minimum of 3 years in claims investigation or fraud detection.
• Experience in the insurance industry preferred.
• Strong investigative procedures, evidence collection, and reporting standards.
• Excellent written and verbal communication skills.
• Ability to work independently and meet deadlines.

Responsibilities

• Conduct thorough investigations into suspicious or potentially fraudulent insurance claims.
• Gather and analyze evidence from policy documents, financial records, and third-party information.
• Interview claimants, witnesses, and relevant parties to obtain factual information.
• Conduct surveillance and background checks as necessary and permissible.
• Prepare detailed and objective investigation reports outlining findings, evidence, and recommendations.
• Liaise with internal claims handlers, legal counsel, and law enforcement agencies as required.
• Maintain accurate and confidential case files, documenting all investigative activities.
• Identify patterns and trends in fraudulent activity to help improve detection methods.
• Ensure all investigative activities comply with legal requirements and company policies in Centurion.

Skills

Interviewing skills

Interrogation skills

Attention to detail

Analytical thinking

Communication skills

Education

Criminal Justice / Law Enforcement qualification

Tools

Investigative databases

Job description

About the Role

Our client, a leading insurance company, is seeking a diligent and detail-oriented Insurance Claims Investigator to join their team in **Centurion, Gauteng**. This role is vital for ensuring the integrity of the claims process by conducting thorough investigations into potentially fraudulent or suspicious claims across various insurance lines. You will be responsible for gathering evidence, interviewing witnesses and claimants, analyzing documentation, and preparing comprehensive reports to support claims decisions. The ideal candidate possesses strong observational skills, an inquisitive mind, and a solid understanding of investigative techniques within the **Gauteng** insurance landscape. This is an excellent opportunity for someone looking to build a career in claims management and fraud detection.

Key Responsibilities

• Conduct thorough and impartial investigations into suspicious or potentially fraudulent insurance claims.
• Gather and analyze evidence, including reviewing policy documents, financial records, and third-party information.
• Interview claimants, witnesses, and other relevant parties to obtain factual information.
• Conduct surveillance and background checks as necessary and permissible.
• Prepare detailed and objective investigation reports outlining findings, evidence, and recommendations.
• Liaise with internal claims handlers, legal counsel, and law enforcement agencies as required.
• Maintain accurate and confidential case files, documenting all investigative activities.
• Identify patterns and trends in fraudulent activity to help improve detection methods.
• Ensure all investigative activities comply with legal requirements and company policies in **Centurion**.

Requirements

• A relevant qualification or certification in Criminal Justice, Law Enforcement, or a related field is preferred.
• Minimum of 3 years of experience in claims investigation, fraud detection, or a related investigative role, ideally within the insurance industry.
• Strong understanding of investigative procedures, evidence collection, and reporting standards.
• Excellent interviewing and interrogation skills.
• Keen attention to detail and strong analytical and critical thinking abilities.
• Proficiency in using various investigative tools and databases.
• Excellent written and verbal communication skills.
• Ability to work independently, manage caseloads, and meet deadlines in a demanding environment within **Gauteng**.
• Discretion and a high degree of integrity are essential.

Benefits

• Competitive salary and potential for overtime pay.
• Company vehicle or travel allowance.
• Comprehensive health and wellness benefits.
• Opportunities for specialized training in forensic investigation.
• A stable and supportive work environment.