Insurance roles – investigator

Role summary

The Investigator is primarily engaged by an insurer to gather information from the insured and "investigate" a claim and provide information as to the validity of a claim.  They are often engaged to verify the autheticity of a claim.

The role of investigator can also at times include surveillance particularly in worker's compensation, personal injury (public liability) and life insurance type matters.

Key accountabilities

  • Gather and analyse relevant information in a timely fashion
  • Review and understand various policy wordings
  • Provide efficient and effective service to clients
  • Carry out on-site enquiries and investigations as required
  • Obtain high quality information by investigation in a timely manner (supported where required by site notes, photographs, witness statements, and other appropriate evidence) so as to be able to properly conclude on policy liability, legal liability, quantum, subrogation and risk management issues in Compliance with prevailing client requirements
  • Preparation of reports in the appropriate format, ensuring that they demonstrate the added value of our involvement
  • Where appropriate, ensure the correct use of preferred suppliers/consultants/experts
  • Communicate effectively and proactively with all relevant parties by the most effective and expeditious means, prioritising the use of telephone and email contact
  • Ensure Insurers (and brokers if appropriate) are kept fully updated on all relevant matters throughout the life of the claim
  • Ensure all relevant parties have a clear understanding of the role of the adjuster, the process and requirements at any one time
  • Maintaining detailed and accurate records of all site visits, meetings discussions, decisions and key milestones
  • The proper escalation of claims or issues either outside license or as required by company
    procedures
  • Actioning of any complaints in accordance with company procedures
  • Manage workloads and diary systems so as to ensure a high level of compliance with prevailing service standards
  • Ensure that files  (electronic or paper) called for audit (internal or external) are reviewed and supplied in a timely manner, ensuring they  have been reviewed, are complete, legible and accurate from a process and technical perspective
  • To meet prevailing revenue and output targets
  • Willingness to work flexibly outside normal working hours
  • Willingness to work flexibly outside normal geographical area when surge or other circumstances require, supporting other divisions as appropriate
  • Seek to identify innovative solutions to all claim issues and minimise elapsed time of claim lifecycles
  • Maintain a high degree of knowledge and usage of company IT systems
  • To maintain a high degree of knowledge and competence in respect of technical issues pertinent to liability claims
  • To act at all times in a smart, professional and courteous manner
  • To participate positively and constructively as a team member, sharing knowledge and providing feedback and suggestions
  • To support promotional and marketing activity as required, seeking to identify new business leads wherever possible

 Experience/knowledge    

  • Minimum 3 years of claims or investigating experience
  • Member of the Chartered Institute of Loss Adjusters
  • Excellent communicator with sound negotiation and investigation skills
  • Ability to work both as part of a team and under own initiative
  • Ability to work accurately under pressure, adhering to strict deadlines and service standards
  • Good degree of IT literacy/competency
  • Full driving license
  • Ability to maintain a flexible approach at all times

 Personal attributes           

  • Ability to build obtain and analyse relevant information
  • Ability to build valuable relationships with clients that are based on mutual respect
  • Ability to source, challenge, integrate and reconstruct diverse sources of information to identify, analyse and determine trends, inaccuracies in data and proactively develop solutions
  • Ability to develop, implement, manage and deliver multiple projects in an environment that is resource and time constrained with high demands for service quality, technical expertise and results
  • Ability to identify, analyse and proactively resolve problems
  • Excellent analytical and problem solving skills 

Education/qualifications/other
requirements

  • Prior Insurance experience
  • Senior Associate/Fellow of the Australian and New Zealand Institute of Insurance and Finance (Desirable or working towards)

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