US Jobs US Jobs     UK Jobs UK Jobs     EU Jobs EU Jobs

   

Workers Compensation SIU Investigator

Chubb is the world’s largest publicly traded property and casualty insurer.

With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients.

The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

As a critical part of the Workers Compensation Claim discipline, this position is responsible for collaborating with internal and external colleagues to:

 

·         Analyze first reports of loss, underlying file material, and/or underwriting file, to determine if claim is suspect or potentially fraudulent

·         Conduct a complete, in-depth investigation to develop sufficient evidence to determine the claim handling decision

·         Recommend a final course of Claim action- substantiation of legitimate claim, or denial of an unjustified claim, and/or a recommendation of further punitive action to successfully execute the above.

·         Collaborating and communicating with the following during the investigation: Claim Department, Claim Operations, Loss Control Department, Underwriting Departments, Agents Counsel, Insured’s and/or their Legal Representatives, National Fraud Manager, Law Enforcement, Regulatory Agencies, and Industry Anti-Fraud Organizations

·         Developing and maintaining excellent relationships with all of the above

·         Ensuring strong customer service and relations at all times

·         Managing (selecting, directing, employing, and maintaining) private investigator panel of independent contractors and other vendors for quality and cost effective results

·         Maintaining and monitoring an active diary, properly documenting all developments in claim file, preparing investigative reports, maintaining suspicious claim database, and preparing reports on a quarterly basis to supervisors

·         Being familiar with and appropriately adhering to fraud statutes

·         Actively pursuing memberships in professional anti-fraud investigative organizations and participating in associated training and events offered

·         Training and influencing Claim, Loss Control and Underwriting colleagues as well as Insured’s to detect and prevent insurance fraud

·         Adhering to Chubb service standards, Chubb code of professional conduct, statutory regulations, and Unfair Claims Practice Acts

·         Ensuring the character and reputation of an insured, claimant, or other party is positively maintained- not maligned or criticized as well as ensuring that investigations have a clear, single focused intent of uncovering and providing necessary facts to expedi...




Share Job