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- Independence, OH
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Special Investigator - Desk Investigator
Permanent General Companies, Inc. • Independence, OH
Posted 1 month ago
The General® is seeking a Special Investigator I (Desk Investigator) to remotely investigate assigned claims suspected of insurance fraud and other irregularities.Responsibilities
- Investigations include but are not limited to taking detailed statements from material parties and witnesses, collection of evidence for review and analysis, gathering of information using databases, law enforcement agencies, public records and other available sources.
- Maintain assigned claim files in a confidential manner; documents all relevant facts pertaining to those files.
- Provide adjusters and claims management with regular updates regarding status of investigations.
- Manage investigative vendor assignments/tasks and ensure vendors submit accurate final reports regarding their findings according to established deadlines.
- When suspected fraud is detected, submit thorough reports regarding details of the incident and the investigation to Departments of Insurance and other appropriate law enforcement officials.
- Coordinate and consult with legal department on claim investigations and attend and/or conduct Examinations under Oath with Legal Counsel when appropriate.
- Ensure that local Special Investigative Unit and Claims Department are complying with pertinent state regulations regarding the handling of claims and the investigation of suspected fraud.
- Create, organize, and instruct regular training programs for claims staff on subjects related to the detection of fraud.
- Testify in civil and criminal courts.
- Other duties as assigned.
- 3 - 5 years of claims adjusting or SIU experience with knowledge of investigative techniques.
- Must have an in-depth understanding of insurance coverages and be able to develop investigative action plans in accordance with the coverage being investigated.
- Be able to interact with and provide ongoing training to claims staff
- Be able to develop contacts with local fraud bureaus, district attorney offices, law enforcement agencies, and insurance associations in multiple venues.
- Bachelor’s degree with 5 or more years of work experience required.
- Insurance industry designations such as FCLS, FCLA, and/or CFE preferred.