We are seeking an Investigator for our Special Investigations Unit (SIU) to cover Eastern MA, Southern NH, and Southern ME with the primary investigative area focused in the Northern MA and Boston Metropolitan area. The mission of the Special Investigations Unit (SIU) is to contribute to claims accuracy by building fraud awareness and investigating questionable cases to save our insured thousands of dollars in unwarranted claims.
SIU Investigators work in partnership with claim handlers across all lines of business to investigate potentially fraudulent or suspicious claims. The Field Investigators are the "eyes and ears" of the SIU on the ground, performing investigations based on established law enforcement techniques. They visit loss sites, interview witnesses, conduct recorded statements, take photos, and inspect physical evidence. Field investigators typically have a background in federal, state and/or local law enforcement.
Reporting to the SIU Manager, the SIU investigator will be responsible for developing and executing effective investigative plans in an efficient and timely manner. The SIU Investigator will conduct thorough and impartial investigations to support the accurate resolution of insurance claims by the Company.
• This SIU Investigator will reside in the field (and will be responsible for Eastern MA, Southern NH, and Southern ME) with a focus in Northern MA and Boston Metropolitan area. The investigator is expected to have face to face interaction with parties to a loss, including insured, claimants, witnesses, experts and other professionals on a routine basis.
• Investigative assignments may include claims with identified suspicious loss indictors, definable inconsistencies, or those which otherwise require a high level investigative skill and/or local in person presence.
• The investigator must understand and exhibit appropriate investigative behaviors and methods while handling all aspects of a claim under investigation; including development of the facts, due diligence around evidence collection and interviews.
• The Investigator must be able to clearly and effectively communicate investigative findings in writing and in discussions with Claim and SIU personnel.
• The Investigator will also be responsible for understanding fraud trends within his or her area of responsibility and leverage knowledge gained to SIU analytical resources.
The SIU Investigator is charged with the following responsibilities:
• Independently complete investigations in accordance to The Hartford's core performance values and best practices with minimal direction.
• Prepare and submit investigative reports detailing and documenting all phases of an investigation to assist in the resolution of the claim.
• Recognize intelligence opportunities through active investigations and shares this information with in SIU.
• Interface with SIU Community and Law Enforcement:
• Participate in industry meetings and is able to effectively share and gather significant information. The Investigator must be able to liaison with industry peers and where necessary, interface appropriately with law enforcement per prescribed jurisdictional requirements
• Effectively communicate with claim handlers to understand the facts and circumstances associated with the loss, policy considerations, and other pertinent issues to design effective investigative plans; obtain the critical facts and evidence and ensure that all communications are timely. The Investigator should identify opportunities to schedule roundtable meetings to discuss evidence development and solicit feedback.
• Maintain a clear understanding of investigative techniques and the laws pertaining to insurance claims and mandated fraud reporting as well as a general knowledge of legal principles, civil and criminal, pertinent to the investigation of claim activity.
• Continually enhance investigative skills and understanding of emerging issues impacting property and casualty and group benefit claims.
• Provide support to claims partners and other departments within the Company, which may include identifying training needs; participation in developing and presenting training and mentoring of external business partners and internal staff. Qualifications:
- College degree preferred
- 3 years insurance investigative claims experience preferred
- Law enforcement experience preferred
- Strong interviewing and communication skills, both verbal and written
- The ability to work well independently and in a team environment
- Consistent high level of performance & achievement over career span
- Solid understanding of SIU or relevant claim processes, practices, and applicable laws and regulations
- Strong critical thinking and analytical skills; ability to make deductions; logical and sequential thinker
- Excellent written and verbal communication and diplomacy skills, inspiring confidence among main customers
- Effective time management skills, proactive execution of investigative plans, and flexibility are necessary to ensure the effectiveness of this position
The SIU Investigator is a remote (work from home) position that should reside in the general vicinity Eastern MA/Southern NH/Southern ME.
A company car, cell phone and wireless laptop is provided. Travel: 70%