Senior Special Investigator

Assurant•Florida Virtual, FL

3d•$64,900 - $108,200

About The Position

The Senior Special Investigator protects organizational assets by preventing payment of fraudulent claims in accordance with applicable laws and policy provisions. The role gathers facts about losses while avoiding actions that could expose the company to bad-faith damages. The investigator handles complex, sensitive, and high-exposure cases across multiple entities or functions, using advanced knowledge of property and casualty insurance products, policies, claims procedures, and insurance-fraud laws. The role also supports other investigators, subsidiaries, clients, and company staff, and may direct external investigative vendors.

Requirements

At least 10 years of property and casualty SIU or fraud investigation experience, relevant fraud-industry investigation experience, or prior law-enforcement investigative experience at detective rank.
Field investigation experience.
Strong attention to detail and organizational skills, including the ability to work to deadlines, adapt to changing conditions, and manage multiple tasks concurrently.
Ability to manage relationships with internal and external customers.
Ability to work independently and collaboratively, using sound judgment in decision-making.
Excellent oral and written communication skills and strong analytical skills.
Proficiency with Microsoft Office products, including Excel, PowerPoint, and Word, and claims-related software programs.
Experience taking complex statements from multiple parties to an event.
Ability to gather a broad range of evidence and draw conclusions from objective details related to potential fraud.
Ability to organize and prioritize workload, perform multiple tasks, and devise solutions to problems.
Ability to manage a high volume of investigations while keeping status reports timely.

Nice To Haves

Knowledge of Florida property fraud.
Bachelor’s degree in Criminal Justice or relevant work experience.
CFE, CIFI, or FCLS designation.
Residence in Florida is ideal.

Responsibilities

Conduct timely investigations of suspected fraudulent claims to support prompt and accurate claims decisions.
Conduct complex recorded interviews and investigations to validate claims or identify people and organizations involved in suspicious activity.
Lead high-exposure, high-profile, sensitive, and complex investigations, including major cases involving organized provider rings, staged accidents, large losses, and broad-scale property and casualty schemes.
Apply advanced knowledge of property and casualty insurance products, policy contracts, coverage, claims handling processes, and procedures to investigations.
Apply knowledge of state laws and regulations pertaining to insurance fraud.
Collect and accurately process detailed information and evidence through field or remote interviews and searches of investigative databases, internal and internet resources, public records, and forensic tools.
Maintain confidential claims files and document relevant facts in the appropriate claims handling system.
Refer suspicious or fraudulent activity to State Insurance Departments, fraud bureaus, and the National Insurance Crime Bureau (NICB).
Initiate civil or criminal actions based on investigative outcomes.
Maintain investigative databases.
Assist Assurant subsidiaries and accounts with investigations.
Conduct fraud training for new hires, clients, and company staff as needed.
Assist the SIU Manager with claims assignments as needed.
Request, prepare, and document examinations under oath or sworn statements, and may conduct them, including in cases involving attorney representation.
Obtain, evaluate, and summarize law enforcement reports, credit reports, medical documentation, and affidavits related to losses, including documentation required from relevant parties under state and federal regulations.
Review and interpret medical records, reports, and billing in injury-loss investigations.
Testify at depositions, hearings, and trials.
Develop and maintain rapport with local information networks, including law enforcement, vendors, and industry experts.
Manage budgets and direct outsourced investigations to vendor partners.
Act as a resource to other Special Investigators.
Gather evidence and draw conclusions from objective details to assess whether fraud is applicable.
Handle a high volume of investigations and provide timely status reports.