Sr Complex Investigator, SIU

Description

Sr Complex Investigator - SIU - This role owns a caseload of the highest complexity field claims, investigating fraud indicators through critical thinking, fieldwork, desktop tools, and vendor partnerships. You'll work independently across high exposure and high-risk jurisdictions, making compensability determinations on suspicious losses and organized schemes, including staged accident rings and provider fraud, across all lines of business supported by the SIU. Field work or vendor usage is required on most or all investigations.

What You'll Do

Investigation & Case Leadership

• Independently build and execute investigation strategy for high complexity field claims
• Independently lead in-depth interviews with claimants, witnesses, and other participants
• Conduct detailed field investigations in adherence with SIU procedures and best practices
• Gather evidence and independently determine compensability
• Engage experts, vendors, and investigative tools as warranted
• Communicate investigation outcomes to line of business field claims personnel and fully execute the field claim decision process on non-compensable findings

Litigation Support

• Partner on complex litigation, occasionally assisting with litigation preparation and representing or testifying on behalf of the company at trials, mediations, and arbitrations

Technical Expertise & Mentorship

• Serve as a subject matter resource to claims personnel
• Provide fraud awareness training and advanced technical advice to internal stakeholders
• Support the training unit in developing fraud-training modules

Partnerships & Intelligence Sharing

• Maintain a strong network with law enforcement agencies, collaborating on investigations of suspicious losses
• Proactively partner with line of business field claims personnel to generate referrals and evaluate whether to open organized scheme investigations
• Share intelligence and emerging trends with Personal Lines or Business Lines SIU and other internal stakeholders
• Represent the company at industry association meetings, training industry SIU personnel and law enforcement as needed

Special Projects

• Participate in and lead special projects as assigned

Ideal Experience Includes:

• 5+ years experience within SIU

Qualifications

• Bachelor degree or equivalent training, plus at least 7 years of investigative or insurance investigation experience
• Demonstrated ability to conduct extensive and complex suspicious loss investigations and/or lead organized scheme investigations
• Strong interpersonal, analytical and negotiation skills required
• In depth knowledge of legal liability, investigative procedures, general insurance policy coverage, State and Tort Laws needed

Employees may apply for a new role after completing 12 months of employment in their current position.

Employees should review all role requirements and apply only for positions for which they are eligible. Hiring processes may vary by country, including differences in procedures, requirements, and timelines. For country-specific details, please consult your local recruiting / HR team.