Senior Investigator

1 month ago

Durban, KwaZulu-Natal, South Africa Pineapple Full time

Our company, Pineapple Tech PTY LTD, is seeking a highly skilled Senior Investigator to join our team in Durban, KwaZulu-Natal. As a key member of our short-term insurance claims department, you will play a crucial role in investigating motor, contents, and all-risk claims.

About the Role
  • This position involves conducting thorough investigations, collaborating with experts, and making informed decisions on claims approvals.
  • You will be responsible for in-person meetings with clients, ensuring effective communication and validation of claims to ensure policy terms and conditions are met.
Key Objectives and ResponsibilitiesField Investigation and Documentation
  • Investigate motor, contents, and all-risk claims thoroughly.
  • Draft supporting documentation, understanding its purpose and relevance (e.g., reasonable requests).
  • Photograph and measure accident scenes, conduct contents inventories, and validate findings.
Claims Assessment and Decision-Making
  • Evaluate claims against company policies and underwriting guidelines.
  • Makes informed recommendations for claims approval or denial based on investigation outcomes.
  • Document investigation processes and findings clearly for internal review.
Risk and Compliance Oversight
  • Ensure compliance with internal and external regulations regarding claims assessments.
  • Identify potential fraud or discrepancies in claims submissions and escalate as necessary.
Operational Efficiency
  • Collaborate with Claims Agents and team members to streamline claims assessment processes.
  • Contribute to the development and implementation of best practices in claims investigation and assessment.
Reporting and Feedback
  • Provide regular updates on claims assessment metrics, including investigation findings.
  • Participate in team meetings to discuss ongoing cases and share insights on claims processing improvements.
RequirementsEducational Background & Qualifications
  • A degree in Forensic Science, Investigation, or a related field is required.
Experience
  • Minimum 2-3 years of experience in multi-skilled on-the-road investigation within the short-term insurance industry.
  • Prior experience in fraud detection or a related investigative role in the short-term insurance industry is desirable.
Skills and Competencies
  • Attention to detail: Handle documentation and communications precisely.
  • Strategic thinking: Strong analytical problem-solving skills and ability to make informed decisions based on data analysis and technological tools.
  • Tech-savvy: Proficient in investigation software, data analytics tools, and AI-driven fraud detection solutions.
  • Communication & collaborative skills: Ability to effectively communicate investigation findings to various stakeholders.
Compensation Package

We offer a competitive salary package, estimated to be between R250,000 and R400,000 per annum, depending on experience and qualifications. A reliable vehicle is also required to fulfill the responsibilities of this role.

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