Fraud Investigator (Home Team)

Company Description

Ready to join a team that’s leading the way in reshaping the future of insurance? We’re on a mission to revolutionize insurance for good! Since 2000, we’ve been a trusted provider of Home and Motor Insurance, serving over 2 million customers through our esure and Sheilas’ Wheels brands. With a bold commitment to digital innovation, we’re transforming the way insurance works—putting customers at the heart of everything we do. Leveraging advanced technology, data-driven insights, and exceptional service, we’re delivering personalized experiences that meet today’s changing needs.

Job Description

Purpose of Role:

• Investigate both opportunist and premeditated/organised motor claim fraud (including but not restricted to Staged collisions, Induced collisions, Suspect theft, Fabricated events).
• Investigate both opportunist and premeditated/organised home claim fraud (including but not restricted to Accidental loss, Theft, Accidental damage, Escape of water).
• Investigation of customers and third parties to prevent pecuniary loss to esure. Deliver robust counter fraud message to claimant and their representatives.
• Support and deliver outstanding customer journey where our insured has been the victim of fraud.
• Provide support/mentoring for Investigators new to role until competent.

What will my role entail?

• CPD Accreditation: Minimal Level 2 in Advanced Validation Solutions (Digilog techniques) or equivalent building to Level 3 in Advanced Validation Solutions and Level 3 in Mentor in Risk Screening.
• Expert knowledge of motor and home policy cover including limits and exclusions.
• Responsible for timely triage and validation of referrals from multiple sources to determine if fraud concerns exist.
• Responsible for all Investigation activities from cradle to grave on retained cases.
• Responsible for gathering and presenting evidence obtained from claims data supplied, industry and open-source investigation as required.
• Instruct and manage external suppliers on a case-by-case basis (cost/benefit) and ensure clear concise instructions provided to maximise return.
• Accountable for sense check on all evidence gathered before submission for peer sign off on cases for repudiation.
• Accurately record investigation process and evidence obtained (pre/post repudiation) to ensure suitability for potential litigation and/or law enforcement referral.
• Responsible for maintaining accurate case data for internal MI applications and shared databases such as SIRA, IFIHUB.
• Complete audits on other internal teams and external suppliers.
• Identify and report leakage via internal form and/or SAR as required.
• Present evidence at civil/criminal trial on owned cases.
• Provide feedback on good outcome cases and/or areas noted for improvement into general claims teams.
• Responsible for review and sign off for claims submitted for repudiation and/or guidance feedback as required.
• Responsible for accurate check and approval of payment requests.
• Responsible for completion of ongoing delegated tasks including team audit, exception reports and others.
• Deputise for Team Leader as required (currently limited to specific individuals).
• Identify and escalate areas for improvement in current counter fraud process inside and out with enterprise fraud.
• Develop capabilities of Investigators new to team/role.
• Create and deliver counter fraud training as required across the business both policy and claim.

Qualifications

You are a good fit for the role if you have the following…

• CPD Accreditation: Level 2 or Level 3 qualification in Advanced Validation Solutions.
• Proven fraud investigation experience in a dedicated motor/home claims fraud investigation role.
• Detailed knowledge of UK insurance claims including liability/personal injury/credit-hire.
• Ability to work outside fixed linear processes to achieve results and guide/mentor others to do the same.
• Ability to work effectively without constant supervision.
• Ability to prioritise own work and still deliver on team/dept KPI requirements.
• Experience of identifying linked metrics from claims/policy to recognise and develop fraud rings.
• Practical experience of Civil litigation and ability to provide concise and timely instructions to panel solicitors.
• Previous experience of attending civil or criminal trials to provide verbal support of witness statements.
• Comfortable with Microsoft Office suite of applications and ability to adapt to changing claims handling systems.
• Strong capability to effectively communicate technical information at all levels commensurate with the recipient’s ability to understand.

We’d also like to hear if you have…

• Detailed practical knowledge of UK motor insurance and proven investigation capability that can be readily transferred to motor/home claims.
• Experience of conducting audits within a claims fraud environment.
• Experience in delivering counter fraud training within a UK insurance environment.

We’ll help you gain…

• Skills to refine/improve investigation capability.
• Access to a wide range of accredited and non-accredited learning in and out of role.
• On team development/progression.

Additional Information

This is your opportunity to be at the forefront of our game-changing journey and be part of something truly special! Here are some perks to life at esure…

• A competitive salary that recognises your skills and potential.
• A bonus scheme that celebrates your contribution to esure’s success.
• Discounts on our insurance products, for you and your family.
• 25 days annual leave, plus 8 flex days to be taken as and when suits you.
• Benefits just for you: our hub – My Benefits Box – is loaded with perks to choose from, so you can build a personal toolkit to support your health, wellbeing, lifestyle, and finances.
• Grow your career with us: whatever your goals, we’ll support you with hands-on training, mentoring, a LinkedIn Learning licence, access to our exclusive Academies, regular career conversations, and expert partner resources from the likes of Women in Data and Women in Tech.
• Join our communities: our networks give you the chance to connect, learn and share with like-minded colleagues across the business – for work and play.
• More flexibility for you: we’re a proud supporter of the ABI’s Make Flexible Work campaign and welcome you to ask about the flexibility you need.
• Live a healthy lifestyle: we offer lots of support, so you feel like the best version of yourself.
• A helping hand to do your bit for a greener and safer world: we encourage colleagues to use volunteering days to support their local communities.
• Everyday appreciation: praise from your colleagues means the world!

We understand some people may not apply for jobs unless they tick every box. If you are excited about joining us and think you have some of what we are looking for, even if you’re not 100% sure we would love to hear from you.

Seniority level

Mid-Senior level

Employment type

Full-time

Job function

Legal

Industries

Insurance

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