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AUD Fraud Investigation at Chubb in Los Angeles, California

Posted in Accounting 30+ days ago.

This job brought to you by eQuest

Type: Full-Time





Job Description:

Description
Chubb is the world’s largest publicly traded property and casualty insurer. Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
 
Chubb has maintained its reputation and financial stability with underwriting expertise, unparalleled customer service, unique industry-specific specialization and a deep respect for all of our employees.
Our award winning Claim organization has a current job opportunity for an SIU Investigator supporting our Workers Compensation & Casualty lines of business.
 
Position Duties and Responsibilities:
As a critical part of the Casualty Claim discipline, this position is responsible for collaborating with internal and external colleagues to:


  • Analyze first reports of loss, underlying file material, and/or underwriting file, to determine if claim is suspect or potentially fraudulent

  • Conduct a complete, in-depth investigation to develop sufficient evidence to determine the claim handling decision

  • Recommend a final course of Claim action- substantiation of legitimate claim, or denial of an unjustified claim, and/or a recommendation of further punitive action to successfully execute the above.

  • Collaborating and communicating with the following during the investigation: Claim Department, Claim Operations, Loss Control Department, Underwriting Departments, Agents Counsel, Insured’s and/or their Legal Representatives, National Fraud Manager, Law Enforcement, Regulatory Agencies, and Industry Anti-Fraud Organizations

  • Developing and maintaining excellent relationships with all of the above

  • Ensuring strong customer service and relations at all times

  • Managing (selecting, directing, employing, and maintaining) private investigator panel of independent contractors and other vendors for quality and cost effective results

  • Maintaining and monitoring an active diary, properly documenting all developments in claim file, preparing investigative reports, maintaining suspicious claim database, and preparing reports on a quarterly basis to supervisors

  • Being familiar with and appropriately adhering to fraud statutes

  • Actively pursuing memberships in professional anti-fraud investigative organizations and participating in associated training and events offered

  • Training and influencing Claim, Loss Control and Underwriting colleagues as well as Insured’s to detect and prevent insurance fraud

  • Adhering to Chubb service standards, Chubb code of professional conduct, statutory regulations, and Unfair Claims Practice Acts

  • Ensuring the character and reputation of an insured, claimant, or other party is positively maintained- not maligned or criticized as well as ensuring that investigations have a clear, single focused intent of uncovering and providing necessary facts to expeditiously resolve a claim in a quality manner

 
Knowledge & Skills:

  • Strong expertise in suspect claim identification and handling

  • High level of acumen in the areas of investigation, listening, strategic/analytical thinking, problem solving, and innovative thinking

  • Strong knowledge of general industry trends and legislative activities in regard to fraudulent claim handling, tort reform, fraud statutes, and civil/criminal procedures

  • Clear interest in and quality execution of "deeper" level investigations

  • Strong interpersonal/ relationship skills- proven ability to build and maintain excellent customer relationships in all situations; success with being a positive "face" to customers; ability to investigate through relationships; acumen to build and maintain successful relationships with internal colleagues as well as local law enforcement, attorney general employees, and insurance bureaus

  • Highly proficient collaboration expertise- ability to work with a diverse team of internal and external colleagues to successfully complete an investigation and provide superior customer service

  • Desire and acumen for training and influencing others in respect to the execution of an investigation and how to identify fraud proactively: Examiners, Underwriters, Producers, Customers, Loss Control, etc.

  • Excellent verbal and written communication skills

  • Ability and desire to work with confidence, autonomy, initiative, and ambition

  • High level of dependability, accountability, and integrity

  • Travel required

  • College degree preferred

  • Law enforcement experience a plus; prior Casualty SIU investigation experience or Casualty claims background a plus

 
 
Chubb strives to offer a diverse and inclusive and rewarding work environment.  Teamwork and mutual respect are central to how Chubb operates and we believe the best solutions draw upon diverse perspectives, experiences and skills.  We operate in such a way where everyone, regardless of their singular background has the opportunity to contribute to our collective success.