Day-to-Day Responsibilities
Review flagged motor, health or property claims for red flags such as mismatched dates, duplicate bills or inflated repair estimates.
Use data tools and fraud-detection rules to find patterns across claims, such as repeat claimants, linked vehicles or unusual hospital billing.
Carry out field investigations by visiting sites and interviewing claimants, witnesses and garages.
Verify documents such as medical records, police reports, bills and identity proofs.
Prepare clear investigation reports with evidence that can stand up to internal review or legal scrutiny.
Coordinate with claims adjusters, underwriters, legal teams and, where needed, police.
Recommend whether to settle, reject or refer a claim for legal action, and feed outcomes back to improve fraud rules.


