Household Claims Validations Co-ordinator

Household Claims Investigations are recruiting for positions within the Claims Validation Team. We are looking for individuals who are passionate about protecting the interests of Admiral and our policy holders.

The Claims Validation Team (CVT) are responsible for reviewing suspect Household and Travel Claims before deciding whether further investigation is required to determine a claims authenticity. Once a claim is retained for investigation CVT may investigate suspect claims by desktop investigation, including Conversation Management, or with the aid of a field investigator, and our specialist supply chain.

Positions within CVT are exciting, interesting and extremely varied given the vast array of claims that can be presented fraudulently against a Household Insurance policy. We receive and investigate all types of claims, from accidental damage to laptops through to total loss Arsons. The lower value claims typically are investigated by desktop investigation, utilising Cognitive Interview techniques such as Conversation Management. Whereas the higher value, and more complex losses are usually investigated in partnership with a field investigator.

If you have a passion for fraud identification and prevention, have an enquiring mind, strong attention to detail, and enjoy a challenging role, then this may be for you.

We are currently looking for individuals to fill investigation and conversation management roles. Please do not be put off if you have no investigation experience, as full training will be provided.

Main Duties and Responsibilities

• Thorough screening and assessment of suspect Household and Travel insurance claims, ensuring suspect claims are run through relevant databases to assist with detection.
• Appointing external counter fraud suppliers to assist with investigation of suspect claims.
• Providing guidance on correct handling procedures when claims are not retained for investigation.
• Conducting conversation management calls where appropriate.
• Managing a case load of suspect claims through to conclusion, including agreeing and arranging settlement with policy holders and their appointed representatives.
• Ensuring relevant material misrepresentations are referred to Claims Underwriters.
• Advising underwriters of any appropriate action required in respect of policies following claims investigations.
• Accurately recording fraud savings.
• Conduct trials and projects to increase detection and prevention of fraudulent claims.
• Act as claims point of contact (both internal and external) for Household fraud matters.
• Preparation of statements and evidence packs for proven fraudulent claims for referral to IFED.
• Assist in preparing and delivering counter fraud training to the Household Claims department, including missed opportunity audits.
• Understand referral processes, referral criteria and authority levels, and ensure these are strictly followed.
• Perform any other duties as reasonably requested according to the needs of the Household claims department or company to ensure business targets are achieved.
• Ensure that we are TCF and act in a professional manner at all times. Handlers will be responsible for ensuring that customer information is safeguarded at all times and we follow the Data Protection Act 2018.
• Meet and exceed departmental Key Performance Indicators and targets.

Training and Experience

No formal training and education is necessary other than a sound educational background and an enquiring mind.  Any Insurance or Investigation Qualification is an advantage.

Experience

The desired candidate should have a background in claims or an investigation based role. It would be advantageous if you were aware of the types of claims that a Home insurer may consider suspicious.

• Cert CII qualified or wiliness to study for the qualification would be advantageous.
• Knowledge of the Data Protection Act 2018 would be advantageous.
• Knowledge of the Fraud Act 2006 would be advantageous.

Behavioural Skills

• Strong attention to detail
• Excellent listener
• An inquisitorial mind
• Ability to deal with customers empathetically without cognitive bias, while remaining alert to claims that may appear suspicious
• Be able to think quickly, creatively and laterally
• Have a passion for Fraud identification and willingness to combat fraud
• Adapts easily to change and retains knowledge
• Ability to display confidence and professionalism when challenging policy holders regarding concerns
• Ability to manage a case load
• Data Protection Awareness
• Effective time management and organisational skills
• Good written and verbal communication skills
• Team player
• Flexible attitude