SIU Field Investigator

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description The Special Investigative Unit Senior Consultant I is responsible for investigating and analyzing complex and occasionally highly complex, multi-discipline coverage and claims that have been referred to the Special Investigative Unit (SIU) for potential fraud. The role typically handles a combination of complex attorney represented and unrepresented claims and complex losses and claims involving extra-contractual liability, large fire and property losses in which suspicious activity has been identified. The individual performs a thorough investigation including (1) conducting background searches, scene investigations, and clinic inspections; (2) taking recorded statements; (3) reviewing and analyzing medical notes, bills and property damage; and (4) conducting witness interviews and social media searches. The individual reviews whether fraud can be substantiated and supports a lawsuit. We are seeking an experienced SIU Investigator to join our growing team! This role is responsible for conducting complex fraud investigations across multiple lines of business, including Auto, Homeowners, and Specialty Lines. This is a field-based position supporting a territory within approximately a three-hour radius of Chicago, IL. Prior investigative experience is required, with a strong preference for candidates who have a Special Investigations Unit (SIU) background and a proven track record of identifying, investigating, and resolving suspicious claims. Key Responsibilities • Makes claim decisions regarding complex and occasionally highly complex investigations, and pursues restitution • Manages, researches, and resolves complex and occasionally highly complex customer communications, concerns, conflicts or issues • Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads • Conducts thorough investigations of complex and occasionally highly complex multi-discipline claims and ECL claims that are potentially fraudulent to determine if payment is warranted • Utilizes analytic tools or SIU field intelligence to identify complex and occasionally highly complex claims for investigation and/or for support in the evidence of the fraud and damages • Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision making process • Enters SIU claim data information into multiple SIU systems • Updates files with investigation outcome, and when no fraud, or if insufficient evidence is found, returns file to MCO for further handling and settlement • Reviews investigations with fraud outcomes to validate whether denial is appropriate • Conducts complex and occasionally highly complex online data application searches, research, and evaluation Supervisory Responsibilities • This job does not have supervisory duties. As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment. Applicants seeking an adjuster role who also hold a resident producer license must formally surrender that license when instructed to by the licensing team. By proceeding with the application process, applicants acknowledge and accept these licensing requirements and agree to comply. #LI-KR1   Skills Analyti