SIU Field Investigator
Esurance - San Jose, CA

This job posting is no longer available on Esurance. Find similar jobs: Siu Field Investigator jobs - Esurance jobs

Summary:
Conducts thorough field investigations and analyzes evidence to determine whether or not fraud has occurred. Defends the company against fraudulent claims and activity, and acts as a technical expert providing investigative expertise and assistance both on an individual and team basis.

***This position will encompass the San Francisco Bay area as well as the Central Valley.

Job Responsibilities:
  • Investigates special investigation unit claims to include:
uninsured motorist property damage exposures, disputed cancellations, disputed policy in-force, thefts, burned vehicles, single/multiple party losses, questionable damage claims, low-impact losses, loss operating expense claims, prior losses, questionable referrals, first/third party injuries, pre-text claims, provider investigations, complex multi-carriers task force investigations and nation crime information center status.
  • Analyzes results of investigations to determine course of action; documents activities of injury and material damage claims handling practices.
  • Conducts in-person interviews and obtains detailed in-person recorded statements from all involved parties.
  • Requests, prepares, documents, conducts examinations under oath and/or sworn statements including those involving attorney representation.
  • Conducts thorough searches using insurance investigative databases, internal resources such as Intellishare, internet resources, and public records to locate parties and collect evidence to determine if potential fraud exists.
  • Obtains, evaluates and summarizes law enforcement reports, credit reports, medical documentation and affidavits in relation to loss including documentation from required parties in accordance to state and federal regulations.
  • Reviews and interprets medical records, reports, and billing in relation to injury loss investigations.
  • Renders opinions on investigative findings through written reports and recommends whether to take further actions.
  • Completes vehicle inspections and obtains fluid samples to investigate alleged damages in relationship to loss.
  • Conducts clinic inspections (state specific) and neighborhood canvases and on-scenes to include diagrams, measurements and/or light sequence.
  • Analyzes vehicle photos to investigate alleged damages in relationship to loss.
  • Testifies at depositions, hearings and trials.
  • Develops and maintains a rapport with local information networks to include law enforcement, vendors and industry experts.
  • May conduct branch training.
Qualifications:
  • Detail-oriented with strong organizational skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.
  • Demonstrated ability to manage relationships with both internal and external customers.
  • Demonstrated ability to work effectively under pressure and within a collaborative team oriented environment using sound judgment in decision-making.
  • Excellent communication skills both oral and written with strong analytical skills to effectively investigate suspected insurance fraud
  • Excellent customer service and solid negotiation skills.
  • Demonstrated proficiency with Microsoft Office products (Excel, PowerPoint, and Word) and claims related software programs.
  • Demonstrated knowledge of coverage, policy interpretation, exposure recognition and liability determination to analyze and move investigations forward.
  • Understands and able to interpret property damage and bodily injury claims terminologies and processes.
  • Must be able to travel daily within assigned geographical areas.
Experience / Education:
  • Bachelor’s degree in Business Administration, a related field, and/or equivalent education required.
  • Three years special investigation unit insurance experience and/or detective/investigator within law enforcement preferred.
  • Property damage experience preferred.

Esurance - 2 years ago - save job - copy to clipboard
About this company
41 reviews
Born online, raised by technology, and majoring in efficiency, Esurance offers consumers an easier, more modern way to manage insurance....