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Fraud Investigator

4 months ago


Kawana, Australia Auto & General Full time

About us

At Auto & General (A&G), we provide smarter products and solutions to safeguard our customers in their time of need. Our range of general insurance products protect customers on the road, at home and on holiday with various Car, Motorcycle, Home, Contents, Pet and Travel Insurance products as well as Roadside Assistance.

Our culture of ‘high performance with high integrity’ underpins our values and the way we interact with our customers, the community and each other. We’re excited about the future and we’re always on the lookout for talented, passionate individuals who can help us achieve our goal of being Australia’s best insurer If this sounds like you, apply today.

The role

This role is responsible for investigating, assessing and finalising complex or suspicious claims to prevent and detect fraudulent insurance activities. The Investigations Consultant also provides specialist support and advice to other Claims & Assessing teams. This role is Kawana-based only.

  • Coordinate the services that may be required by policy holders following an incident.
  • Develop an Investigation Plan (as required) and review and seek approval from CIU Team leader.
  • Perform objective, fair, and timely investigations and adhere to high standards of regulatory compliance.
  • Review complex or suspicious cases and prepare investigation plans, including identifying missing or inconsistent data.
  • Investigate complex and suspicious claims or insurance related activities by interviewing clients and sourcing additional information via online tools.
  • Act as a first point of contact for customers regarding queries and establish excellent rapport.
  • Engage and liaise with external investigation services to access additional information.
  • Make acceptance or rejection decisions for claims based on sound evidence and liaise with customers to advise of outcomes.
  • Provide support on potentially fraudulent claims escalated to Customer dispute resolutions prior to and post submission to Ombudsman.
  • Provide reporting and guidance regarding investigated claims to other Claims & Assessing teams.
  • Participate in behavioural fraud investigation training, as well as other up-skill sessions, and apply new techniques.
  • Deliver consistently high levels of customer service to achieve set performance targets.
  • Manage personal portfolio of claims effectively and assist other team members when necessary due to workload demands.
  • Conduct interviews of policy holders and any other relevant stakeholder, record statements as required and write records of all interviews.
  • Interviewing individuals who may have information on fraud allegations.
  • Participate proactively as a team member, or autonomously, to achieve the outcomes within a Compliance Framework.
  • Maintain understanding of up to date industry trends in terms of fraudulent/ criminal activities and technological advances.
  • Maintain sound knowledge of regulatory requirements, company processes, systems, products, and Auto & General brands.
  • Prepare reports, maintain records, and keep track of evidence trails and interview statements.
  • Manage multiple cases with confidence and accuracy and respond well to working to meet targets and tight deadlines.
  • Researching audio or video surveillance and carefully assess to validate events.
  • Examining a range or series of information during investigations, which may also include the policy’s holder background.
  • Reviewing and researching evidence/documents to analyse the overall fact pattern of claim and synthesize data into a professional report with recommendations.
  • Writing in-depth reports on your findings and presenting them to management.
  • Always act in good faith, with respect and integrity.
  • Respond to requests made by the relevant stakeholders promptly and professionally and in line with service expectations.
  • Assist Senior Manager: Fraud & Claims investigations and/or CIU Team Leader with additional projects or tasks.

What experience you’ll bring

  • Certificate IV Financial Services highly regarded.
  • Certificate III Investigative Services highly regarded.
  • Previous experience in conducting investigation interviews, highly regarded.
  • Excellent working knowledge of insurance legislation and processes.
  • Excellent interpersonal skills, including written and verbal communication, with the ability to build client rapport.
  • Excellent problem solving and decision-making skills.
  • Excellent negotiation and conflict resolution skills.
  • Good computer and administration skills.
  • Good time management skills.
  • Ability to work autonomously and build professional resilience.
  • Well developed and demonstrated understanding of the legislative, regulatory and compliance obligations to operate in the FSR environment

Our perks

  • Extra leave - Enjoy additional leave days on us You’ll receive a paid ‘ME’ day and one paid volunteer leave day annually. Team members can also purchase up to two additional weeks of leave per year.
  • Paid parental leave - We support our new parents with paid parental leave and other benefits.
  • Workplace giving - If you’re passionate about a cause, then we are too – we offer workplace giving and we’ll dollar match your donations to registered charities.
  • Development opportunities - We’re championing your development with internal programs and access to a wide range of online courses.
  • Employee discounts - You’ll receive discounts on Budget Direct insurance products.
  • Reward and recognition - We reward high performance with employee recognition, reward and incentive schemes.
  • Onsite facilities - There’s excellent end-of-trip facilities on offer and private spaces for nursing mothers.
  • Get social - Join our vibrant social and community activities including annual celebrations, family fun days and regular events across each of our sites.
  • Perks App - Access to an employee benefits and discounts app called ‘Perks’ offering your great discounts, offers and programs across a range of areas.

If you are seeking a new challenge and would enjoy the opportunity to work in a growing and changing business, click on the APPLY NOW button and submit your application.

Auto & General values individual differences and believes in fostering an inclusive culture that creates a great place to work for all.

*A note from Auto & General to recruitment agencies: We politely ask that you avoid making any approaches or sending any unsolicited resumes to our Recruitment Team or Hiring Leaders across our business. Auto & General is not responsible for any fees related to unsolicited resumes.