Specialist: Forensic Investigator

PPS Recruitment; Centurion; On-site; ZAR 420,000 - 620,000; Full time

Job summary

PPS Recruitment seeks an analytical Forensic Investigator in South Africa to conduct investigations into insurance claims and white-collar crime, identifying fraudulent activity and gathering reliable evidence.

The successful candidate will protect policyholder value, minimise fraud losses, and strengthen internal controls while ensuring fair and accurate claims assessment in line with regulatory requirements.

Qualifications

• 5+ years of forensic investigation experience in financial services.
• Experience in life/short-term insurance and claims environment.
• Experience interviewing claimants, witnesses, and brokers.
• Experience with evidence files, case dockets, and reporting.

Responsibilities

• Investigate referred insurance claims and fraud leads across the case lifecycle.
• Obtain, verify and preserve documentary, digital and physical evidence.
• Plan and conduct fair, structured interviews and document admissions.
• Identify indicators of non-disclosure, altered documents, impersonation, collusion.
• Produce defensible forensic reports outlining facts and recommendations.
• Provide claims with timely findings to support valid claims and action on fraud.
• Compile case dockets and support litigation processes.

Skills

Data analysis

Investigative skills

Attention to detail

Ethical integrity

Strong judgement

Stakeholder management

Education

Bachelor's degree in Forensic Investigation or related

CFE or CFIP certification

SA insurance legislation knowledge

Driving license

Tools

Excel

Power BI

Power Query

Case management software

Job description

We are looking for an analytical, ethical, and results-driven Forensic Investigator to join our team. In this role, you will conduct investigations into insurance claims and white-collar crime, identifying fraudulent activity and gathering reliable evidence to support informed decision-making.

The successful candidate will play a key role in protecting policyholder value, minimising fraud-related losses, and strengthening internal controls, while ensuring that legitimate claims are assessed fairly, accurately, and in line with regulatory and business requirements. This position requires strong investigative skills, sound judgement, attention to detail, and a commitment to integrity and accountability.

Education:

• Matric / Grade 12.
• Bachelor's degree or relevant qualification in Forensic Investigation, Forensic Auditing, Internal Audit, Risk Management, Accounting or Commerce.
• Certified Fraud Examiner (CFE), Certified Forensic Investigation Professional (CFIP), forensic auditing certification or relevant postgraduate qualification.
• Knowledge of South African insurance and financial-services legislation and requirements, including the Insurance Act, Long-term Insurance Act where applicable, Financial Sector Regulation Act, Financial Intelligence Centre Act, Protection of Personal Information Act, and Treating Customers Fairly principles.
• Exposure to insurer policy wording, underwriting disclosures, claims assessment, repudiation considerations, recoveries, litigation support and referrals to the South African Police Service or other authorities.

Experience:

• At least 5 years of forensic investigation experience in a similar role, including substantive experience in life insurance, disability/income protection insurance, short-term insurance, banking or a comparable financial-services claims environment.
• Demonstrable experience investigating suspected claims fraud, misrepresentation, non-disclosure, identity/document fraud, staged or exaggerated losses, collusion and other white-collar crime matters.
• Experience interviewing claimants, witnesses, brokers/intermediaries, employers, service providers and suspected perpetrators, and obtaining formal statements.
• Experience compiling investigation reports, evidence files and case dockets for disciplinary, civil recovery, regulatory or criminal processes.
• Experience with data analysis, fraud red flags and trend detection using Microsoft Excel, pivot tables, Power Query, Power BI or comparable investigation tools.
• Valid South African driver's licence and access to a reliable vehicle, with willingness to travel and conduct fieldwork, sometimes at short notice.

Duties and Responsibilities

Claims investigations:

Investigate referred insurance claims and fraud leads across the full case lifecycle, including planning, information gathering, fieldwork, interviews, evidence analysis, findings and closure.

Evidence management:

Obtain, verify and preserve documentary, digital and physical evidence while maintaining confidentiality, chain of custody and a complete case audit trail.

Interviews and statements:

Plan and conduct fair, structured interviews with relevant parties; test inconsistencies; and accurately document statements and admissions.

Fraud and misrepresentation assessment:

Identify indicators of material non-disclosure, false declarations, altered documents, impersonation, collusion, duplicate claims, fabricated events and exaggerated incapacity or loss.

Reporting and recommendations:

Produce clear, objective and defensible forensic reports setting out facts, evidence, policy implications, control failures and recommended action.

Claims decision support:

Provide Claims with timely, properly investigated findings that support the payment of valid claims and appropriate action on invalid or fraudulent claims.

Legal and enforcement support:

Compile case dockets and support disciplinary, civil recovery, litigation and criminal referral processes, including giving evidence when required.

Fraud prevention:

Analyse cases and data for recurring patterns, emerging typologies and process gaps; recommend improvements to controls, referral rules and fraud-prevention measures.

Stakeholder management:

Build effective working relationships with Claims, Underwriting, Legal, Compliance, Risk, Internal Audit, brokers/intermediaries, employers, external investigators and law-enforcement stakeholders.

Service delivery:

Manage allocated matters within agreed service levels, maintain accurate case records and communicate material delays, risks and outcomes appropriately.