Handle complex, high-exposure bodily injury claims with limited supervision. Responsibilities include investigating claims, evaluating coverage, liability, and damages, negotiating settlements, managing litigated files, maintaining reserves, presenting selected claims to committees, and mentoring teammates. The role requires strong judgment, communication, negotiation, problem-solving, and relationship-building skills, along with experience working with attorneys and complex claims.

Investigates suspected insurance fraud across auto, property, casualty, workers’ compensation, and specialty lines. Reviews claims and policy files, identifies red flags, gathers and documents evidence, conducts field and desktop investigations, coordinates investigative vendors, and prepares detailed reports. Partners with claims, underwriting, legal teams, regulators, law enforcement, and fraud bureaus. Provides fraud detection training and uses investigative databases and AI-enabled tools to support analysis and decision-making.

Investigates suspected insurance fraud across auto, property, casualty, workers’ compensation, and specialty lines. Leads complex investigations, organized fraud cases, evidence gathering, interviews, investigative action plans, vendor coordination, and detailed reporting. Collaborates with claims, underwriting, legal partners, regulators, fraud bureaus, and law enforcement. Serves as a subject matter expert, mentor, and trainer on fraud detection, prevention, and investigative methodology.