Claims Investigator

2 weeks ago


Sunshine Coast, Australia Youi Pty Ltd Full time

The role of an Investigator at Youi is focused on conducting thorough and transparent investigations of insurance claims to ensure the best outcomes for both the business and the customers.

**The role involves several key responsibilities**:

- **Triage Claims**: Assess incoming claims to determine whether investigations are required. This involves an initial evaluation to understand the circumstances of the claim and whether an investigation is required to reach the right outcome on the claim.
- **Conduct Investigations**: Investigate claims across various risks to detect and prevent fraud and policy breaches. This likely involves gathering evidence, conducting interviews, obtaining statements from involved parties, critically analysing documentation and information and evaluating policy terms and conditions.
- **Claims Forum**: Present the findings of your investigations at our internal Claims Forum. This will involve sharing your insights, analysis, and recommendations to ensure transparency and informed decision-making.
- **Decision-Making**: Make informed decisions in line with Youi’s Claims Philosophy based on the investigations conducted. These decisions could pertain to the validity of claims, coverage eligibility, and potential actions to be taken.

**About you**:

- **Experience**: Prior experience in conducting interviews, obtaining statements, would be beneficial for success in this role.
- **Presentation Skills**: The ability to present investigation findings confidently at the Claims Forum is important.
- **Knowledge**: Familiarity with Part 15 - Claims Investigations Standards of the General Insurance Code of Practice is crucial for adhering to industry standards.
- **Problem-Solving**: Ability to analyse complex situations, identify issues, and develop solutions is important for conducting thorough investigations.
- **Empathy and Communication**: Effective communication and empathy are essential for interacting with customers, understanding their situations, and conveying decisions.
- **Negotiation Skills**: You might need to negotiate with various parties to gather information, resolve disputes, and ensure fair outcomes.
- **Logical Thinking**: A logical mindset is valuable for analysing evidence, identifying patterns, and drawing sound conclusions.
- **Results-Driven**: A focus on achieving the best outcomes for both customers and the business is key.

**Pros and Cons of the role**:
The best part of the job is working to find a balance between looking after customers' and the company's interests. No two days are the same and this role provides variety and challenges.

On the other hand, one of the challenging aspects is making unfavorable decisions that can have financial implications for customers. This requires a delicate balance between empathy and adherence to policies.

**Consideration**:
The role is mostly remote, with one day per week in the office at Head Office. It also involves managing a portfolio of 15 investigations.

For more information or to express interest, reaching out to Madison Radford is suggested.

This role is suitable for individuals with a background in investigation, strong interpersonal skills, and an understanding of insurance practices, particularly claims investigations. It offers a mix of challenges and rewards, with a focus on fairness and transparency for both customers and the business.

Reach out to Madison Radford with any questions.



  • Sunshine Coast, Australia Auto & General Insurance Full time

    Work Type : Full Time Location : QLD - Flexibility to be based in Toowong, North Lakes or Kawana - Great benefits; bonus scheme, discounted products & paid volunteer day - Lead a high performing team passionate about delivering results **About us** At Auto & General (A&G), we provide smarter products and solutions to safeguard our customers in their time...

  • Investigator

    7 days ago


    Sunshine Coast, Australia Youi Pty Ltd Full time

    As a Claims Investigator at Youi you will focus on conducting thorough and transparent investigations of insurance claims to ensure the best outcomes for both the business and the customers. You will work from home four days a week and **one day a week in the office** with your fellow Youi team at our state-of-the-art Head Office in Sippy Downs. **This...

  • Investigator

    1 week ago


    Sunshine Coast, Australia Youi Pty Ltd Full time

    **Think Youi** From Day One, Youi has set out to do things differently. Our company values are easy to explain - We are dynamic, human, honest and passionate about providing awesome service, whilst recognising our people and their achievements. These values drive our culture and success. We have now assembled an incredible team, work in a state-of-the-art...


  • Sunshine Coast, Australia Open Full time

    **Role** Complex Claims Specialist **Department** Customer Operations **Location** Sunshine Coast or Melbourne - Hybrid **Schedule** Full-time **Open Insurance**: We’re on a mission to provide the best insurance experiences, at the best price, for the world. Come join us! **The team**: You will join our Technical Claims team, working with a carefully...


  • Sunshine Coast, Australia Youi Pty Ltd Full time

    **Responsibilities**: - Handle and process insurance claims related to catastrophic events, ensuring accuracy and efficiency. - Communicate with customers in a compassionate and professional manner, providing support and guidance throughout the claims process. - Investigate and assess the extent of damage, loss, or injury to determine coverage and...


  • Sunshine Coast, Australia Youi Pty Ltd Full time

    **Purpose of the role** Manage complex claims end-to-end, using expertise to deliver strong outcomes for intermediated customers. 18 Month Fixed Term Contract. **Key priorities** - Manage 80-100 complex property and SME claims end-to-end. - Ensure timely resolutions and optimal financial outcomes. - Investigate and adjust large, complex claims. - Build...


  • Gold Coast, Queensland, Australia beBeeCareer Full time

    Strata Claims SpecialistThe role of Strata Claims Specialist involves utilizing your skills to resolve insurance claims, examining reported losses to establish cause, liability, and quantum, with the customer and client at the center of your work.This specialist works closely with clients and customers to determine the extent and cause of loss through...


  • Gold Coast, Queensland, Australia beBeeClaim Full time $90,000 - $120,000

    **Strata Insurance Claims Expert**This role involves resolving insurance claims and examining reported losses to establish cause, liability, and quantum. The ideal candidate will have previous loss adjusting experience with a focus on Strata claims, understanding of the complete claims management lifecycle, and ability to build and maintain key client...

  • Claims Consultant

    1 week ago


    Gold Coast, Australia HUB24 Group Full time

    HUB24 leads the wealth industry as the best provider of integrated platform, technology and data solutions. At HUB24, we know the smartest investments start with our people. We are innovative and ambitious, and we move fast. At HUB24, we empower our employees to bring their ideas and creativity to work. Rather than getting bogged down in bureaucracy and red...


  • Sunshine Coast, Australia The Andersen Partnership Full time

    Competitive salary package above market rate - Fully remote role - Generous bonus scheme on offer Are you a meticulous and detail-oriented professional seeking a rewarding career in the insurance industry? Look no further! We are partnered with a leading insurance company, that is seeking a skilled External Loss Adjuster to join their dynamic...