Claims Fraud Investigator

7 days ago

Toronto, Ontario, Canada AIG Full time
About the Role

We are seeking a highly skilled Claims Fraud Investigator to join our team at AIG. As a Claims Fraud Investigator, you will play a critical role in identifying and investigating suspicious insurance claims and activities, ensuring the integrity of our claims process and protecting our business from potential losses.

Key Responsibilities
  • Conduct thorough investigations of medium-to-high complexity suspicious insurance claims or activities, covering all lines of business, to identify potential fraud and recommend appropriate actions.
  • Obtain and preserve physical and documentary evidence to support investigations, and coordinate necessary investigative techniques and resources.
  • Handle caseloads across relevant jurisdictions, ensuring all tasks are completed properly and efficiently.
  • 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, analyzing results and suggesting improvements.
  • Accurately identify and record all financial impact for cases worked in the case management system.
  • Assist GIS and local management 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, including analyzing facts, reviewing interviews and statements, and gathering facts through open-ended interviewing and statement taking.
  • 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, analyzing results and suggesting improvements.
Requirements
  • College degree preferred or equivalent work experience.
  • Advanced knowledge of criminal and civil justice systems and relevant data and compliance legislations.
  • Excellent oral and written communication skills and thorough working knowledge of MS Office applications.
  • 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.
About AIG

AIG is a global leader in commercial and personal insurance solutions, with a reputation for delivering innovative and effective risk management solutions to our customers. We are committed to creating a culture of belonging, where our employees feel valued, respected, and empowered to succeed. We foster a culture of inclusion and belonging through our flexible work arrangements, diversity and inclusion learning, cultural awareness activities, and Employee Resource Groups (ERGs). We are proud to be recognized as a leader in diversity and inclusion, and we are committed to continuing to drive positive change in our industry.

AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability, or any other legally protected categories. We are committed to working with and providing reasonable accommodations to job applicants and employees with disabilities.

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