Job Title: Internal Investigator
Hiring Organization: Kenya
Orient Insurance Limited
Location – Locality: Nairobi
Location – Region: Kenya
Industry: Insurance
Job Type: Full
Time
Salary: KES
Competitive
Date Posted: 03/27/2024
Purpose Of The Position
- The
Internal Investigator shall be responsible for conducting objective, fair,
thorough, unbiased and timely investigations into allegations/suspicions
of fraud committed by policyholders against the Organization as instructed
by the claims-handling team.
- Record
detailed statements from involved parties and relevant witnesses in
efforts to sieve through cases requiring further investigations by an
external investigator.
- Professionally
and forensically, gather evidence to be used to support claims that may be
fraudulent.
- Compile
investigation reports after collecting data from the field visits within
the laid down timelines and hand over the file to the claims team with
recommendations.
Key
Tasks, Duties And Responsibilities
- Timely
response and visit to risk address/scene of the accident for claims being
reported to collect salient photographic evidence of the scene to
ascertain the extent of damage caused to the client’s vehicle and any
other TPPD that may have been involved.
- Analyze
all investigation reports (both internal & external) to ensure that
they are objective based on material facts admissible by the regulator and
in a court of Law.
- Acts
as liaison between corporate and appointed external investigators/loss
adjusters to facilitate the gathering of information that will allow
proper response to claim losses.
- Investigate,
evaluate and advise on settlement of claims, applying technical knowledge
and human relations skills to effect fair and prompt disposal of cases to
contribute to a sustainable loss ratio.
- Prepare
periodical claims report and other management reports relating to claims
and ensure that any necessary remedial action is taken promptly.
- Ensure
in-depth investigation of claims through direct or indirect contact with
policyholders, claimants, physicians, contractors and advocates ensuring
that any detected fraud case is handled as per company policy guidelines.
- Review
and analyze claims loss and expense reserves established by insurance
carriers.
Requirements
- Bachelor’s
Degree/Diploma in Criminology, Forensic and Criminal Investigations, from
a reputable institution of Higher education.
- Certificate
of Insurance – Fraud Investigator
- At
least 4 years’ work experience preferably in a reputable Investigator firm
or Insurance Company