SIU Field Investigator - National General

About the role

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers' evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.

Responsibilities

• Enters SIU claim data information into multiple SIU systems
• Reviews investigations with fraud outcomes to validate whether denial is appropriate
• Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to MCO for further handling and settlement
• Conducts complex online data application searches, research, and evaluation
• Conducts complex site inspections, including body shops, medical clinics, loss locations etc.
• Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed
• Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
• Sums up documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process
• Utilizes analytic tools or SIU field intelligence to identify complex claims for investigation and/or for support in the evidence of the fraud and damages
• Researches and responds to complex customer communications, concerns, conflicts or issues

Qualifications

• Experienced in conducting complex online data application searches, research, and evaluation
• Experience in conducting complex site inspections, including body shops, medical clinics, loss locations etc.
• Experience in conducting thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed
• Ability to summarize documents and enter into claim system notes, documenting a claim file with notes, evaluations and decision-making process
• Experience in utilizing analytic tools or SIU field intelligence to identify complex claims for investigation and/or for support in the evidence of the fraud and damages
• Experience in researching and responding to complex customer communications, concerns, conflicts or issues

Skills

• Auto Insurance Claims
• Automobile Accidents
• Claims Processing
• Critical Thinking
• Customer Service
• Field Investigations
• Fraud Investigation
• Fraud Investigations
• Information Collection
• Insurance Investigation
• Investigative Skills
• Loss Investigation
• Property Damage
• Residential Property
• Witness Interviewing

Benefits

Benefits details are not specified in the job posting. Please refer to the company's official website or HR department for detailed information.