Fraud Claims Investigator

Location KUALA LUMPUR, Malaysia
Experience level Executive Role
Job details sector Legal and Compliance
Apply before Date not available

Job Summary

  • To assist the FMU team in detection & investigation of fraud claims
  • To assist the FCO in ensuring all cases are duly taken up and the necessary follow up to be monitored consistently and timely
  • Lodging police reports and attending court when necessary
  • To establish good contacts with various government agencies (police, JPJ, National Registration Dept and EPF) and private organizations (telecommunication companies, banks and insurance companies)
  • Monitoring on modus operandi by Fraudsters
  • Maintain a database of all cases reported to the company and status of each case and assisting the Unit head to periodically report such as statistics and summary of cases to the Management 

Overview of tasks

1.      Receive assignment & Open File

a)      To open investigation file by using designated investigation file cover and fill up the necessary file cover details with complete documentations or documents in hand for new assignment.

b)      Follow up assignments- upon further instruction from the TPBI to proceed with investigations basing on existing documents.

 

2.      Study File

a)      To prepare the necessary ground works by scrutinizing all relevant documents prior to commencing an investigation task, e.g.

b)      Evaluate documents, conduct desk investigations and prepare action plans for field investigation.

c)      To have a discussion with the executive in charge for better understanding on the case assigned.

d)      To obtain specific directions on areas of investigation TPBI claims expects on case to case basis.

 

3.      Discuss with Claims Department

a)      To have a discussion with the executive in charge for better understanding on the case assigned.

b)      To obtain specific directions on areas of investigation TPBI claims expects on case to case basis.

 

4.      Perform Investigation

a)      To make arrangement to conduct interview with relevant parties (e.g. insured, custodian, agent, witness, employer, workshop others

b)      To conduct site enquiry, independent enquiry to firm up ground for claims decision making

c)      To take photos on various aspect and supporting facts in establishing a case.

d)      To obtain relevant documentation e.g. police outcome, police reports, JPJ search, medical reports and others

e)      To observe and act on other aspect that may arise in the course of investigation

 

5.      Update minutes in investigation file

a)      To update diary on every effort made in attending to a case in details narration. This copy is attached to the investigation file. A continuation sheet would be used if necessary.

b)      Attending investigator is to update minutes in the investigation file

 

6.      Draft update report

a)      Investigator to submit draft report either by e-mail or hardcopy for evaluation and editing by their respective team leaders –[FMU]

 

7.      Unit head to review

a)      Finalised report is forwarded to the Unit Head for review, approval & Submission


Minimum Degree in any field related to Risk, Fraud & Compliance
Minimum 2 years of working experience in Fraud 
Positive personality and willing to work extra mile


Would you like to wake up every day driven and inspired by our noble mission and to work together as one global team to empower people to live a better life?  Here at AXA we strive to lead the transformation of our industry. We are looking for talented individuals who come from varied backgrounds, think differently and want to be part of this exciting transformation by challenging the status quo so we can push AXA - a leading global brand and one of the most innovative companies in our industry - onto even greater things.  

 

In a fast-evolving world and with a presence in 64 countries, our 166,000 employees and exclusive distributors anticipate change to offer services and solutions tailored to the current and future needs of our 103 million customers.


https://www.axa.com.my/


AXA Affin General Insurance Berhad is a joint venture between AXA Group and Affin Holdings Berhad. We are one of the fastest growing general insurance companies in Malaysia, and the No.1 leader in Medical and Health insurance (source: ISM). We provide comprehensive and tailored protection solutions to individuals and businesses in the areas of Motor, Home, Accidental, Travel and Commercial insurance. 
We pride ourselves in conducting business responsibly, and building long-term relationship of trust when serving almost a million Malaysian customers, with over 800 employees in 22 offices, as well as over 4,000 agents nationwide, as well as our brokers and key bank partners.





We are the best organization that demonstrate drive, commitment and tenacity to champion diversity and inclusion with workplace practices that enable our current & future employees to achieve work-life integration. 
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