SIU Field Investigator - National General

National General is part of The Allstate Corporation, offering home, auto, accident, health insurance, and other specialty niche insurance products through a large network of independent insurance agents and directly to consumers.

About the role

This role is responsible for investigating and analyzing complex, multi-discipline coverage and claims referred to the Special Investigations Unit (SIU) for potential fraud. The position handles a combination of complex attorney-represented and unrepresented claims, as well as moderate to complex losses where suspicious activity has been identified. This is a field-based position located in or near Bronx, Manhattan, Westchester, or surrounding areas in New York.

Responsibilities

• Enter SIU claim data into multiple SIU systems.
• Review investigations with fraud outcomes to validate whether denial is appropriate.
• Update files with investigation outcomes; return files to MCO for further handling if no fraud or insufficient evidence is found.
• Conduct complex online data application searches, research, and evaluation.
• Perform site inspections, including body shops, medical clinics, and loss locations.
• Investigate potentially fraudulent claims through scene investigations, surveillance, and other methods to determine if payment is warranted.
• Validate information obtained through investigations and follow up on all possible leads.
• Summarize documents and enter them into claim system notes, documenting evaluations and decision-making processes.
• Utilize analytic tools or SIU field intelligence to identify complex claims for investigation and gather evidence of fraud and damages.
• Research and respond to complex customer communications, concerns, conflicts, or issues.
• Conduct background searches, scene investigations, clinic inspections, and take recorded statements.
• Review and analyze medical notes, bills, and property damage.
• Conduct witness interviews and social media searches.
• Perform surveillance and create scene reconstructions on some investigations.
• Provide work guidance, mentoring, and coaching to less senior employees.

Requirements

• Individuals holding an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments during employment.
• Applicants seeking an adjuster role who also hold a resident producer license must formally surrender that license when instructed by the licensing team.

Skills

• Documentation
• Law Enforcement
• Special Investigations

Pay

Base compensation offered for this role is:

• SIU Cons I: $60,000 - $87,400
• SIU Cons II: $62,100 - $92,700
• SIU Sr Cons I: $68,500 - $104,100

Compensation is based on experience and qualifications. Total compensation includes base pay plus incentive pay (e.g., commission, bonus) if applicable.

Benefits

• Comprehensive technology setup, including a laptop, monitors, headset, keyboard, and mouse.
• Monthly connectivity reimbursement to help offset internet costs for eligible remote employees.
• Equal Opportunity Employer – Veterans/Disabled and other protected categories.

Candidates must possess authorization to work in the United States; sponsorship for work visas is not provided.