Job Purpose
The Insurance Investigation Officer is responsible for identifying, examining, and resolving suspicious, exaggerated, or fraudulent insurance claims. The position involves evaluating evidence, cross-verifying official document repositories, and conducting field inquiries to minimize financial loss from fraudulent claims while ensuring valid, honest claims are settled quickly and fairly.
Key Responsibilities & Duties
1. Case Evaluation & Evidence Gathering
- Review claim files flagged by automated anti-fraud triggers, analytical systems, or claims handlers for potential anomalies.
- Conduct exhaustive field inspections of accident sites, damaged physical properties, or commercial locations to reconstruct events.
- Examine local police records, trace First Information Reports (FIRs), seek Panchanamas/Rough Sketches, and look into Motor Vehicle Inspector (MVI) reports.
2. Document & Background Verification
- Check the authenticity of legal, medical, and financial declarations (including hospital billing summaries, treatment histories, and wage structures) to root out pre-existing health issues or phantom procedures.
- Cross-examine digital public repositories, regional vehicle registration systems, and court dockets (via platforms like e-Courts) to review the structural history of the claimants.
- Perform comprehensive background profile traces, checking credit status logs and open-source public social media footprints to cross-verify physical injuries.
3. Interviews & Field Inquiries
- Conduct tactful, objective interviews with claimants, de-facto informants, eye-witnesses, medical personnel, and law enforcement officers to secure descriptive statements.
- Coordinate surveillance procedures when necessary to determine whether a claimant's daily activities contradict their stated physical constraints.
Pay: ₹15,000.00 - ₹25,000.00 per month
Benefits:
Work Location: In person
