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    Internal Investigator at - Nairobi, Kenya - Kenya Orient Insurance Limited

    Kenya Orient Insurance Limited
    Kenya Orient Insurance Limited Nairobi, Kenya

    1 week ago

    Default job background
    Full time
    Description

    The company was incorporated in 1982 by the Al Fateem Group of Dubai and was later acquired by Kenyans in 1988.

    Kenya Orient Insurance was then formed in 2004 after a transfer of ownership from the previous proprietors to its current owners.

    We have since enjoyed steady growth as a company and are fast becoming a force to reckon with in the industry.


    PURPOSE OF THE POSITION

    The Internal Investigator shall be responsible for conducting objective, fair, thorough, unbiased and timely investigations into allegations/suspicions of fraud committed by policyholders against the Organization as instructed by the claims-handling team.

    Record detailed statements from involved parties and relevant witnesses in efforts to sieve through cases requiring further investigations by an external investigator.

    Professionally and forensically, gather evidence to be used to support claims that may be fraudulent.

    Compile investigation reports after collecting data from the field visits within the laid down timelines and hand over the file to the claims team with recommendations.

    KEY TASKS, DUTIES AND RESPONSIBILITIES

    Timely response and visit to risk address/scene of the accident for claims being reported to collect salient photographic evidence of the scene to ascertain the extent of damage caused to the client's vehicle and any other TPPD that may have been involved.

    Analyze all investigation reports (both internal & external) to ensure that they are objective based on material facts admissible by the regulator and in a court of Law.

    Acts as liaison between corporate and appointed external investigators/loss adjusters to facilitate the gathering of information that will allow proper response to claim losses.

    Investigate, evaluate and advise on settlement of claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases to contribute to a sustainable loss ratio.

    Prepare periodical claims report and other management reports relating to claims and ensure that any necessary remedial action is taken promptly.

    Ensure in-depth investigation of claims through direct or indirect contact with policyholders, claimants, physicians, contractors and advocates ensuring that any detected fraud case is handled as per company policy guidelines.

    Review and analyze claims loss and expense reserves established by insurance carriers.


    REQUIREMENTS
    Bachelor's Degree/Diploma in Criminology, Forensic and Criminal Investigations, from a reputable institution of Higher education.
    Certificate of Insurance – Fraud Investigator
    At least 4 years' work experience preferably in a reputable Investigator firm or Insurance Company
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