Claim Investigator - Field Work

Role Summary

The Field Claim Investigator is tasked with performing thorough on-site investigations of insurance claims to confirm their legitimacy. This includes collecting evidence, interviewing involved parties, and compiling comprehensive reports to enable fair, prompt claim decisions.

Key Responsibilities

• Carry out field investigations pertaining to insurance claims.
• Visit medical facilities, insured individuals, and other relevant sites to verify claim information.
• Gather and authenticate medical documentation and corroborating evidence.
• Conduct interviews with claimants, healthcare professionals, employers, and witnesses when necessary.
• Prepare detailed and punctual investigation reports outlining findings and suggestions.
• Adhere to internal policies, regulatory standards, and investigation protocols.
• Work closely with the claims team to address queries related to investigations.

Preferred Candidate Profile

• Educational qualifications: BHMS, BAMS, BPT, B.Pharm, or B.Sc. in Forensic Science.
• Relevant experience in insurance claim investigation, medical investigation, or healthcare sectors.
• Excellent communication, analytical, and report writing capabilities.
• Willingness and ability to travel extensively, roughly 120 km daily.
• Ownership of a two-wheeler or four-wheeler with a valid driving license is mandatory.
• Basic proficiency with MS Office and smartphone apps.

Essential Requirements

• Medical education background is compulsory.
• Possession of own vehicle required.
• Capability to work autonomously and adhere to investigation deadlines.
• High standards of integrity, confidentiality, and meticulous attention to detail.