Insurance Fraud Investigator

Placements24; Bloemfontein; Hybrid; ZAR 360,000 - 480,000; Full time

Benefits offered by this job

Hybrid work model

Medical benefits

Retirement benefits

Training opportunities

Annual leave

Job summary

Placements24 is seeking an Insurance Fraud Investigator in Bloemfontein to join our clients investigations unit. You will conduct proactive and reactive investigations, gather evidence, and prepare comprehensive reports to support claims handling and enforcement actions.

The role requires 3+ years in insurance fraud investigation, strong analytical skills, and the ability to work with law enforcement and legal teams.

Qualifications

• Minimum 3 years of experience in insurance fraud investigation.
• Ability to gather admissible evidence.
• Strong analytical and communication skills.
• Knowledge of common fraud schemes.

Responsibilities

• Conduct investigations into suspected insurance fraud across lines of business.
• Gather evidence, interview subjects, and review documents.
• Prepare detailed reports with findings and recommendations.
• Coordinate with claims, legal, and law enforcement as needed.
• Identify fraud patterns to inform prevention strategies.
• Maintain confidentiality and adhere to ethical standards.
• Testify in court or at hearings when required.
• Assist in developing fraud detection tools and training.
• Collaborate with external parties as necessary.

Skills

Insurance fraud investigations

Analytical thinking

Interviewing skills

Attention to detail

Communication skills

Education

Degree in criminology or related field

Professional certification in investigations (advantageous)

Tools

Investigative databases

Case management software

Job description

About the Role

Our client is actively seeking a sharp and detail-oriented Insurance Fraud Investigator to join their dedicated investigations unit in Bloemfontein, Free State . This role is integral to protecting the company from fraudulent claims by conducting thorough investigations, gathering evidence, and providing comprehensive reports. The ideal candidate will have a keen eye for detail, strong analytical skills, and a solid understanding of investigative techniques within the insurance context. You will work closely with claims handlers, legal teams, and law enforcement agencies to resolve suspicious cases. This is a challenging yet rewarding opportunity for an investigator looking to make a real difference in the fight against insurance fraud in Bloemfontein .

Key Responsibilities

• Conduct proactive and reactive investigations into suspected insurance fraud across various lines of business.
• Gather and analyze evidence, including reviewing documentation, conducting interviews, and surveillance.
• Prepare detailed investigation reports outlining findings, evidence, and recommendations.
• Liaise with internal departments (claims, legal) to provide investigative support.
• Collaborate with external parties, including law enforcement agencies and regulatory bodies, when necessary.
• Identify trends and patterns of fraudulent activity to inform prevention strategies.
• Maintain strict confidentiality and adhere to all legal and ethical standards during investigations.
• Testify in court proceedings or other legal forums as required.
• Contribute to the development of fraud detection and prevention tools and training.

Requirements

• A minimum of 3 years of experience in insurance fraud investigation or a related field (e.g., law enforcement, corporate security).
• Demonstrated ability to conduct thorough investigations and gather admissible evidence.
• Strong analytical and critical thinking skills with excellent attention to detail.
• Excellent interviewing and interpersonal communication skills.
• Proficiency in using investigative tools and databases.
• Knowledge of insurance principles and common fraud schemes is essential.
• Ability to work independently and manage multiple cases simultaneously.
• A relevant degree or professional certification in criminology, law enforcement, or investigations is advantageous.
• Integrity, discretion, and a commitment to ethical conduct.

Benefits

• Competitive annual salary of ZAR .
• Performance-based incentives for successful investigations.
• Comprehensive medical and retirement benefits.
• Opportunities for specialized training in fraud investigation techniques.
• A hybrid work model offering flexibility.
• Join a committed team focused on integrity in Bloemfontein .
• Annual leave and sick leave benefits.