Am, Claims Investigator

2 weeks ago

Kuala Lumpur, Malaysia Allianz Full time

AM, Claims Investigator

**Summary** The Claims Investigator is 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 examiner in progress the claim and will leverage knowledge and expertise to ensure that the fraud risk to Allianz is minimized.

**Key Responsibilities**
- As an Insurance Fraud Investigator, you will be responsible for investigating 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.
- Ability to manage all aspects of the claim's investigation, to include analyzing facts on issues in question, thorough review of interviews and statements of witnesses, employers, claimants, and other relevant witnesses.
- Obtaining and preserving physical and documentary evidence to support investigations.
- Coordinating necessary investigative techniques and resources, such as fieldwork through internal or external field resources, cognitive interviews, etc. and ensuring quality is accurate, timely and appropriate on all cases.
- Producing reports based on evidential findings, providing adjusters with the informationrequired to progress the claim as appropriate.
- Handling caseload across relevant jurisdictions while ensuring all tasks are completed properly.
- Testifying and presenting evidence at administrative and criminal court proceedings as required.
- Establishing and maintaining professional working relationships with insured, claimants, witnesses, lawyers, corporate employees, police, and relevant fraud bodies.
- Identify, create, and complete fraud training for various lines of business as requested by your manager.
- Completing targeted claims reviews for all lines of business within Allianz 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.
- Assisting the Head of Claims Special Unit as appropriate in ensuring key deliverables and business objectives are met.
- Awareness of, and adherence to local laws regarding techniques used for information gather-ing in countries where operating.

**Key Requirements**
- Recognized university degree and/or professional qualification with a minimum of five (5) years relevant experience in insurance claims, investigation, or litigation support.
- Attended courses or seminars related to insurance fraud.
- An understanding of laws that pertain to public and insurance funds is necessary.
- Aware of the legal limits of a private investigation and always adhere to the correct procedures and guidelines.
- Investigative mindset.
- Strong communication, interpersonal, analytical, and problem solving skills.
- Able to manage multiple engagements and deadline driven.
- Good written and communication skills in English and Bahasa Malaysia with factual and ac-curate investigation report writing on findings of cases investigated.

49250 | Customer Services & Claims | Professional | Non-Executive | Allianz Malaysia | Full-Time | Permanent

Job ID 49250

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