Fraud Investigator

Zego

Zego

Accounting & Finance
Halifax, UK
Posted on Jan 23, 2024

We’re a commercial motor insurer on a mission to save people time and money. From Taxi drivers to self-employed scooter delivery riders, our customers are our driving force. We’re making insurance fairer and more human for every one of them.

When we started back in 2016, we knew that traditional insurance held businesses back. It was too complicated, too expensive and too time consuming. So we set out to change things, building insurance solutions that empower professional drivers throughout the UK and Europe.

So far, we’ve raised over $200 million in funding. We’ve grown from a scrappy start-up into an industry changing organisation, and there’s plenty more to come.

That’s where you come in…

Reporting to the Fraud Manager, as a Fraud Investigator you will work as part of a Technology focused fraud team. You will ensure legitimate activity can proceed at pace whilst fraud is proactively detected, investigated, managed and prevented, ensuring the best possible outcome is reached for Zego and our genuine customers.

The fraud investigator will be working with a team of highly skilled and successful fraud experts as well as our new and innovative, API first claims management system to support the delivery of a world-leading Claims service to our UK customers while ensuring the business has access to high-quality claims data and fighting fraud.

Responsibilities:

  • Analyse claims referrals that we receive from internal and external sources against known fraud indicators and other risk factors identifying cases where an investigation is required within authority level
  • Managing your own claims caseload in accordance with the Zego claims philosophy, claims handling procedures and service level agreements consisting of own damage, third party damage and injury claims.
  • Responding proactively to incoming telephone calls and correspondence to avoid leakage and delays
  • Monitoring ongoing credit hire periods to drive down claim costs and raising payments promptly and accurately.
  • Liaising and negotiating with third party insurers and solicitors as well as credit hire organisations to progress and settle claims efficiently, with a pragmatic approach to claims handling
  • Conducting liability and quantum investigations
  • Utilise a variety of desktop tools (CUE, MIAFTR, IFB ) as well as various internet checks and databases to assist with claimant profiling and to determine the direction of the investigation
  • Be responsible for collating fraud data, logging savings and final outcomes of investigations and maintaining claims and fraud MI.
  • Use data analysis to improve rulesets, indicators, processes and provide effective feedback to the business
  • Proactively alert any new Modus Operandi to the intelligence analyst
  • Collaborate with the Fraud intelligence analyst to maintain creating the hub of all Counter Fraud intelligence
  • Ensure compliance with both internal and external protocols and intelligence handling requirements.
  • Pursue follow-up inquiries with external parties including regulatory and licensing authorities, other insurers, and law agencies
  • Validate documents
  • Contribute to the continuous improvement of our sales, underwriting and other processes.
  • Take part in system search trials and provide results to Fraud Management on the results
  • Ensure compliance with all regulatory requirements including 'treating customers fairly' principles and consumer duty rules

Skills required:

  • Able to perform in a fast paced start-up environment
  • Strategic and Inquisitive thinker
  • Counter Fraud experience claims desirable
  • Strong Claims handling experience in an insurance company - desirably with an Insurtech or Motor Insurance provider.
  • Good working knowledge of the MOJ and OIC portals
  • Ability to plan, organise and prioritise own workload.
  • Sound knowledge of liability scenarios as well as a good sense of commercial awareness.
  • A strong understanding of motor insurance indemnity including the Road Traffic Act and Article 75.
  • Enthusiastic and passionate about getting the right outcome
  • Litigation experience (nice to have)
  • Experience in using and maintaining a fraud system
  • Have a good understanding of the Fraud Act 2006
  • An understanding of using telematics in a fraud investigation is not essential but would be nice to have
  • Experience in using Fraud specific software packages and tools ideal