Claims Fraud Investigator

4 months ago

Toronto, Canada AIG Full time

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Fraud Investigator to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team.
Make your mark in Fraud Investigation
Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.
How you will create an impact
As a Claims Investigator, your responsible for all aspects of the investigation process to include creation of investigation plans, identification and assignment of relevant enquiries and reporting on findings. The investigator will provide assistance to the claims adjuster in progressing the claim and will leverage knowledge and expertise to ensure that the fraud risk to AIG is minimized.
Your focus will include investigating medium-to-high complexity suspicious insurance claims or suspicious insurance related activities covering all lines of business involving claimants, brokers, lawyers, medical providers, etc., to support the Claims organization.
**Key Accountabilities**:
Obtain and preserve physical and documentary evidence to support investigations.
Coordinate necessary investigative techniques and resources, such as fieldwork through internal or external field resources, interviews, etc. and ensuring quality is accurate, timely and appropriate on all cases.
Handle caseload across relevant jurisdictions while ensuring all tasks are completed properly.
Testify and present evidence at administrative and criminal court proceedings as required.
Establish and maintain professional working relationships with insureds, lawyers, corporate employees, vendors, police and relevant fraud bodies.
Complete targeted claims reviews for all lines of business within AIG as assigned. This includes analysis, documentation of results and suggestions for improvement.
Accurately identify and record all financial impact for cases worked in the case management system
Assist GIS and local management as appropriate in ensuring key deliverables and business objectives are met.
Awareness of, and adherence to, local laws regarding techniques used for information gathering in countries where operating.
Provide intelligence feedback to claims and underwriting departments regarding loss trends and opportunities for future fraud mitigation.
Manage all aspects of the claims investigation, to include analyzing facts on issues in question, thorough review of interviews and statements of witnesses, employers, claimants and other relevant witnesses.
Gather facts on issues in questions through open-ended interviewing and statement taking of witnesses, employers, claimants, and other relevant witnesses.
Prepare objective and concise written reports of investigations when necessary.
Identify, create, and complete fraud training for various lines of business supported by AIG.
Complete focused claims reviews for all lines of business within AIG domestically as assigned. This includes analysis, documentation of results and suggestions for improvement.
Assist team on ad-hoc duties, projects, and other assignments delegated by Managers/Leaders.
What you'll need to succeed
College degree preferred or equivalent work experience.
Advanced knowledge of criminal and civil justice systems and relevant data and compliance legislations
An understanding of local customs, insurance markets and languages is desired.
Ability to manage workflow to identify and pursue leads that would support a fraud case.
Ability to work to tight timelines when necessary
Advanced working knowledge in investigating General Insurance Consumer & Personal Lines of insurance a plus
Ability to analyze complex data sets to assess trends and identify opportunities to drive improvements
PC skills and experience with various database search systems, internet, and social networking for investigative purposes.
Ready to take your career to the next level? We would love to hear from you.
LI-AIG #claimsprofessionals #FraudInvestigation #FraudInvestigator
Reimagining insurance to make a bigger difference to the world
American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning a

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