Fraud Investigator in Haywards Heath

We're looking for a Fraud Investigator to join our Counter Fraud Services team on a 12‑month fixed term contract based in Haywards Heath, West Sussex or Manchester, Salford Quays. You'll be working as part of a growing, innovative team, responsible for protecting the business and customers from the impact of fraud. You'll be investigating a caseload of suspected fraudulent claims, ranging from low velocity impacts to staged and contrived collisions.

Core skills we're looking for:

• Critical thinking – use your logical reasoning to analyse evidence and draw conclusions about potential crimes.
• Attention to detail – pay close attention to the small detail to uncover evidence of fraud.
• Case management – handle investigations from start to finish, ensuring all necessary steps are taken.
• Investigative techniques – can use various methods for gathering evidence and conducting interviews.

Working flexibly, you'll spend the first three months in the office full‑time for training and support, then move to a hybrid arrangement of four days at home and one day in the office. If you prefer to be in the office more, that's also acceptable.

Responsibilities:

• You’ll carry out thorough investigations and gather evidence on suspected fraudulent claims for personal injury, vehicle damage and credit hire.
• You’ll conduct telephone interviews with customers as well as engaging external suppliers including accident investigators, motor engineers and panel solicitors.
• You’ll assess evidence including intelligence, police reports, medical records and engineering evidence to identify inconsistencies and determine the outcome.
• You’ll identify cases of potential fundamental dishonesty, private prosecutions, or professional enabler involvement.
• You’ll provide advice and support to business areas with regard to potential fraud risks.
• You’ll process payments on claims files as required and in accordance with authorities.
• You’ll ensure claim files are reserved accurately and reserves amended where required.
• You’ll meet agreed fraud KPIs and targets.
• You’ll ensure compliance with company financial crime procedures and related policies.
• You’ll submit suspicious activity reports as necessary to the company MLRO.
• You’ll ensure compliance with consumer duty principles when liaising with customers.
• You’ll build and maintain relationships both internally and externally.
• You’ll be compliant with health and safety policies at all times.
• You’ll ensure compliance with company and other relevant standards and regulations at all times.
• You’ll produce high‑quality written reports and advice for the business, to include recommendations.

Qualifications:

• Proven track record in investigating both opportunistic and organised motor fraud.
• Managing a caseload with adherence to SLAs.
• Proven track record of stakeholder management.
• Strong understanding of motor insurance fraud and the purpose of a Counter Fraud Team.
• Strong understanding of the various indemnity levels and the subsequent impact that this may have on the claim/policy.
• Strong understanding of Part 7 and Part 8 proceedings.
• Strong understanding of the litigation process and the impact that this has on the business both procedurally and economically.
• Strong understanding of regulatory responsibilities (SMRC).
• Excellent knowledge of FCA requirements (including TCF) and the regulatory framework relating to general insurance.
• Strong communication skills, both verbal and written.
• Strong negotiation and influencing skills.
• Strong time management and organisation skills with the ability to prioritise work.
• Strong analytical and problem‑solving skills, with the ability to adopt a logical approach to resolving problems.
• Excellent customer service skills.
• Computer literate, including Word, Excel, PowerPoint and the internet.
• Strong experience of handling fraudulent customer, third‑party damage and personal injury claims.

Behaviours:

• Self‑motivated and enthusiastic.
• Consistently demonstrates a positive attitude.
• Can receive and give constructive feedback.
• Adopts a proactive approach to their workload.
• Identifies and communicates potential process and efficiency improvements.
• Embraces, embeds and incorporates the company values.
• Passionate about reducing the business exposure to fraud risk.
• Emphasis on attention to detail and accuracy.
• Able to work on own initiative and as part of a team.