Claims Investigator- Life Insurance

5 - 10 years

8 - 13 Lacs

Posted:6 days ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Role & responsibilities

Job Overview

The Claims Investigator plays a critical role in safeguarding the integrity of life insurance claims by conducting rigorous investigations into potentially fraudulent or high-risk cases. The role demands sharp analytical acumen, compliance awareness, and effective coordination with internal teams and external agencies. It also includes managing vendors and contributing to continuous risk mitigation strategies.

Responsibilities

  • Conduct thorough investigations on flagged life insurance claims for fraud, anomalies, or discrepancies.
  • Review and analyze supporting evidence: medical records, PMRs, FIRs, employment history, and police reports.
  • Collaborate with forensic experts, legal advisors, and external partners to build a comprehensive case.
  • Prepare detailed investigation reports highlighting findings, recommended actions, and escalation notes.
  • Oversee onboarding of investigation vendors and manage fee processing and records.
  • Monitor investigation KPIs and publish monthly dashboards on fraud trends, resolution time, and vendor performance.
  • Suggest updates to claims processing protocols and preventive fraud controls based on investigation insights.

Requirements:

  • 3-5 years experience in insurance investigations, fraud detection, law enforcement, or financial compliance.
  • Deep understanding of investigation techniques and insurance fraud regulations.
  • Excellent documentation review and information synthesis capabilities.
  • Skilled in interviewing, with high integrity and ethical standards.
  • Proficiency in investigation tools, MS Office, and basic database querying.
  • Capable of managing multiple cases with tight deadlines

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Digit Insurance

Insurance

Bengaluru Karnataka

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