Field Investigator, SIU

MAPFRE • Webster, MA

4d • $58,800 - $87,500 • Onsite

About The Position

Bring your investigative expertise into a highly independent, field-based role that directly supports claims professionals in evaluating losses presented under Personal and Commercial policies. As a Field Investigator, you will manage assigned investigative tasks across Casualty, Physical Damage, No-Fault, Commercial/CCU, and Property claims. Assignments may also include Medical Provider, Underwriting, and Agency investigations, along with other investigative needs as they arise. You will build productive working relationships with federal, state, and local law enforcement and participate in fraud-fighting organizations to strengthen industry knowledge and cooperation. This role requires frequent, timely, and professional in-person contact with customers and the public, may involve training other claims personnel, and may require work outside your assigned territory or regularly scheduled hours based on business needs and assigned tasks.

Requirements

• Bachelor’s degree or a professional level of knowledge in a specialized field, or equivalent related experience.
• Four to six years of experience, or the equivalent of an associate degree plus six to eight years of experience.
• A minimum of four years of claims-adjusting experience involving elements of Physical Damage, PIP, Casualty, and SIU-related issues, and/or five years of professional investigative experience with a law enforcement agency.
• Knowledge of IFB and NICB investigative capabilities and reporting requirements is preferred.
• Knowledge and proper use of M.G.L. Chapter 175, Section 113H, or similar state-specific fraud statutes.

Nice To Haves

• Bachelor’s degree in Criminal Justice or a related field is highly desirable.

Responsibilities

• Deliver an exceptional customer experience
• Understand and comply with all Customer Service Standards, promptly recognize and meet mandated deadlines, and make contact within 24 hours on new assignments.
• Keep internal claims personnel informed of any delays in completing assigned tasks.
• Practice empathy and professionalism in every customer interaction, recognize individual circumstances, and respond promptly to customer needs.
• Conduct thorough, timely investigations of losses and report findings in accordance with company guidelines.
• Make in-person contact with insureds, passengers, adverse parties, and witnesses whenever possible.
• Ensure oral and written communications are timely, clear, concise, and empathetic.
• Demonstrate a commitment to teamwork, take initiative to assist others, properly use voicemail, and promptly return telephone messages.
• Cooperate with law enforcement and other carriers within established guidelines.
• Maintain a professional business appearance when working with customers and agents.
• Conduct high-quality field investigations
• Perform in-person investigations to determine whether fraud exists, evaluate coverage and liability, and identify potential contributors or co-defendants.
• Use appropriate investigative techniques, including meetings with all parties involved in an accident; recorded or written statements and Examinations Under Oath (EUOs); locus investigations, site analyses, and diagrams; scarring photographs; Event Data Recorder (EDR) downloads; witness canvasses; and dram shop investigations.
• Follow practices established in the Claim File Handling Procedures.
• Meet SIU productivity goals by maintaining a current diary, achieving and maintaining reporting standards, using available resources and reference tools, completing other assigned field work, and submitting timely and accurate expense reports.
• Identify, analyze, and recommend automation systems, procedures, or changes that could improve efficiency and productivity from an outside adjuster perspective.
• Apply technical claims and investigative expertise
• Maintain proficiency in Personal, Commercial policies, as well as relevant statutes and case decisions that affect claim adjustment or investigation.
• Identify potentially fraudulent claims and initiate and complete the investigation needed to determine whether fraud exists within the claim.
• Remain current on automobile design and damage repair.
• Operate a laptop and applicable software, with proficiency in Claims Operational Systems, social media research, and SIU software applications.
• Develop and maintain advanced interviewing skills and use established templates.
• Stay current on legal issues involving fraud and arson.
• Attend industry and law enforcement seminars, share observations with peers, join industry-related organizations such as IASIU and NEIASIU, and participate in industry meetings.
• Assist technical personnel in all areas.
• Support defense counsel in preparation for trials, depositions, mediations, and Examinations Under Oath.
• Understand the claims process and clearly communicate necessary information to insureds, claimants, investigators, and attorneys.
• On assigned tasks, perform coverage investigations to determine coverage exposures and the applicability of policy endorsements, limitations, and exclusions. Investigations may include garaging, household member, and regular-use exclusion investigations.
• Conduct independent research as needed to understand local ordinances and rules of the road.
• Understand the litigation process and respond to insureds’ needs when assisting with the completion of interrogatories.
• Lead, collaborate, and model professionalism
• Actively pursue opportunities to mentor and serve as a resource to less experienced adjusters while supporting their professional development.
• Participate in roundtable meetings by presenting cases and recommending actions that bring files and investigations to a conclusion.
• Initiate improvements to workflows, operating systems, and claims service delivery; participate on committees and work teams as needed.
• Consistently demonstrate positive behavior and professionalism in all business dealings.
• Show accountability and dependability through commitment to company standards, procedures, and expectations.
• Continuously strengthen occupational competencies through professional development activities.
• Meet the role’s field and operational requirements
• Maintain a valid driver’s license.
• Keep a personal or company vehicle in good mechanical condition and maintain its professional appearance at all times.
• Assume additional responsibilities as requested.
• Work regularly away from the office and/or outdoors during core and non-core business hours as needed, with exposure to a range of weather conditions.

Benefits

• Tuition reimbursement
• Leadership programs
• Internal mobility opportunities
• Paid Time Off (PTO): A flexible PTO program that combines vacation, personal, volunteer and sick time into one convenient bank of paid time off.
• 401(k) & Profit Sharing: Eligible employees may participate in Mapfre's 401(k) plan that includes company matching contributions up to certain amounts under the terms of the plan.
• Medical, Dental and Vision Coverage: Choice of comprehensive medical, dental and vision insurance coverage under group plans offered by the company.
• STD, LTD, Life Insurance, FSA, HSA and various wellness programs
• $0 Premium Medical Plan Option for employees earning under $75,000 who elect single coverage under our Super Value Plan.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level