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Complex Fraud Negotiator

LocationBexhill-on-Sea

Contract typePermanent Full Time

Reference2513

Hastings Direct, Complex Fraud Negotiator

 

We are looking for a Complex Negotiator to work within our Claims Fraud Team, based in our Bexhill office. You will handle an allocation of complex fraud cases, including fraud ring operations and high value cases. You will also be required to act as a referral point for Negotiators and Senior Negotiators and provide coaching, mentoring and training, monitor the quality and accuracy of work through individual audit reporting and to assist the Claims Fraud Consultant with delegated tasks and responsibilities.

 



 The Role

Working with your Claims Fraud Manager to ensure the team’s quality and development needs are met on a day to day basis.

 

  • To act as a referral point for the other areas of claims fraud, providing coaching, mentoring and training.
  • To assist your Claims Fraud Consultant responsibility for Large Loss reporting, Complex Fraud management and reporting.
  • Ensure that you (and any direct reports) are meeting customers’ fair and reasonable expectations and provide fair outcomes. Question and challenge peers and managers where processes and procedures do not meet these expectations and any activity that does not place customers’ interests at the heart of how we do business.
  • Ensure completion of all training as mandated by the company and regulated by the FCA.
  • Ensure that direct reports and self, achieve and demonstrate levels of competence required to fulfil job requirement
    Working within a team to ensure performance, quality and service needs are met on a day to day basis.
  • To manage you own allocation to the expected standard required
  • To work as part of the Claims Fraud team determined by the needs of Hastings Insurance Services.
  • To maintain and enhance effective working relationships for all internal and external customers.
  • To ensure all work is carried out to a high level of accuracy in line with our documented processes and our company quality and compliance standards.
  • To ensure compliance with company and other relevant standards and regulations at all times including Data Protection, FCA and TCF.
  • It is essential that a good understanding of Claims Fraud is attained.  This is necessary to enable protection of the honest customer.
  • Communicating via telephone (incoming and outbound calls) and written correspondence with policyholder, keeping them updated of all material developments, witnesses, engineers, insurers, solicitors, engineers, third party representatives, medical experts, forensic accountants, rehabilitation providers, case managers, overseas handling agents, investigators, medical agencies, costs draughtsmen, CRU, Counsel, police authorities and third parties in order to bring about resolution of claims.
  • Validation of claims ensuring policy is operational.
  • Realistic, prudent inputting and prompt updating of claims reserves on to IS2000 claims system.
  • To make effective use of diary system within IS2000 in order to maintain proactive approach to claims handling.
  • To ensure each claim is dealt with in line with company/departmental procedure/philosophy and within service standards through to settlement stage in line with personal authorities.
  • To Claims data input work as required using IS2000, GW Claim Centre, GW Policy Centre, Nexus, Microsoft Word, Excel and Access.
  • To interface with relevant departments within the company.
  • Comply with the MOJ, CPR and Pre-Action Protocol when handling personal injury cases in England and Wales.
  • Investigating liability where required, by telephone enquiries, accident report forms, instructing accident investigators, applying for police reports or any other necessary investigations.
  • Making decisions on liability, admitting, disputing or negotiating split settlements.
  • Settle claims in a timely manner, achieving appropriate economic settlements and avoiding financial leakage
  • Negotiating settlement of claims within agreed authority limit or under referral where above.
    Making payments in respect repair accounts, hire accounts, agreed settlement figures in respect of Special and General damages, agreed solicitors costs, rehabilitation and treatment invoices, own agents fees and own solicitors costs.
  • Authorising cheques within authority limit.
  • Negotiating costs were allocated.
  • Arranging medical reports, treatment and rehabilitation where appropriate.
  • Maintaining portfolio by dealing with telephone calls, incoming correspondence and diary to ensure case is up to date.
  • Handling scheme claims within agreed terms and notifying scheme insurer were required.
  • Instructing, under direction from Line Manager or Technical Advisor or Panel Solicitors where proceedings issued and liaising with the same to progress case to settlement or trial.
  • Registering claim with CRU, maintaining up to date Certificates, notifying of settlement, querying any inaccurate benefits and paying any amounts due.
  • Instructing and liaising with appointed agents for foreign claims.
  • Instructing and liaising with appointed medical agencies on both represented and unrepresented injury claims.
  •  Ensure completion of all training as mandated by the company and regulated by the FCA.
  • Ensure that direct reports and self, achieve and demonstrate levels of competence required to fulfil job requirements
  • There is an expected requirement that you will attend all of your own counter fraud trials and possibly those of the teams, which may be at any court in the UK.  (subject to approval)

 

This list is neither exclusive nor exhaustive and there may be other duties, within the remit of this position, required of the job holder from time to time. The Company reserves the right to alter this job description and will do so after consultation with the job holder. 


We’re looking for someone who has: 

  • Excellent problem solving skills
  • Ability to identify inconsistencies between various documents/evidence
  • Effective communications skills with external organisations to include other insurers, solicitors and authorities
  • Basic IT skills
  • Ability to confidently use Microsoft Office Suite
  • Ability to effectively manage own workload
  • Time management
  • Negotiation skills
  • Enthusiastic and committed to operational success. (essential)
  • Previous experience with coaching and mentoring. (essential)
  • Proven knowledge of Claims Fraud. (essential
  • Good experience with litigation and trials. (essential)

  • Good understanding of regulatory requirements and company principles. (essential).

  • Significant claims fraud experience

 

 

 

About us

 

Hastings Direct is a fast growing, agile, digitally focused general insurance provider of products and services to over 2.7 million customers in the UK. We've significantly grown our customer base over the last three years and we now employ over 3,400 colleagues.

It's our attitude and the way we run our business that makes us different. We focus on getting it right for our colleagues, customers, company and community. It's a dynamic, flexible, fun and constantly changing environment. You'll enjoy the scope to make a real difference for our customers, influence our company, benefit the communities we work in and have some fun along the way.

 

Benefits for you  

 

Please find some of the great benefits we offer here at Hastings Direct;

 

  • Competitive basic salary
  • Up to 5% bonus earning potential
  • 25 days holiday plus bank holidays
  • Life assurance
  • Competitive pension
  • Flexible benefits – buy or sell holidays
  • Discounted Hastings Direct products

 

 

Hastings Group is an equal opportunities employer which means we treat people fairly. We welcome applications from all suitably skilled persons regardless of their gender, age, race, disability, ethnic background, religion/belief, sexual orientation, gender reassignment or marital/family status. Please also note that we have a thorough referencing process, which includes credit and criminal record checks 

Bexhill-on-Sea

Conquest House,
Collington Avenue,
Bexhill-on-Sea,
TN39 3LW
About Bexhill-on-Sea

3.3

The shifts in customer service teams are quite colleague friendly. There is free tea and coffee in the call centre, and a subsidised Costa Coffee and canteen. There are lots of incentives to earn more, and a decent social life.

It has a really positive environment with everyone who works there being very helpful. The managers really do go out of their way to assist you. There are a lot of benefits and rewards at Hastings Direct which if you are doing well are quite easy to achieve.

There is a well-rounded approach to the wellbeing of all colleagues, including an inclusive approach to wellbeing activities. Hastings Direct aims to roundly develop colleagues and set them up for future careers within the company.

There is a wonderful work environment, with a strong sense of team work which purveys throughout the business. And there is a sense of friendly competition which works to heighten this.

3.6

As an employer, Hastings Direct offers a lot of company benefits to all employees which are fantastic and I feel this is quite unique. The company culture is inclusive and encourages everyone to participate in local causes.

All employees are well looked after, respected and recognised for the hard work we do for the company. It is a great experience to be working with such amazing team. It much easier for me to balance my work and personal life.

It’s a great place to work with amazing benefits, support and colleagues. Lots of hands on support. Amazing rewards for achieving targets and also plenty of time to get together as a team outside of work and bond with your colleagues.

The company culture, management structure and general atmosphere is really good. The share scheme and Hastings Direct rewards are also fantastic for staff.