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Job Description

Job Purpose:

The Investigator is responsible for carrying out effective and efficient fraud investigations into allegations of suspected fraud within the Britam Retail Segment. The jobholder is responsible for interviewing individuals with information about the fraud, analyzing the relevant documentation, and reporting their findings.

Key responsibilities:

• Undertaking fraud investigations of cases reported to the Group Forensics team from various sources including whistleblowing hotline, customer escalations, letters to Management, Internal Audits, direct tip offs etc.
• Evaluate potential fraud indicators and the impact of current fraud trends and make recommendations as to appropriate mitigation.
• Conducting investigations into allegations of fraud, waste or abuse committed against the Organization. 
• Preparing and coordinating field assignments to obtain relevant evidence and information.
• Conduct objective, fair, thorough, unbiased and timely investigations into allegations of fraud, waste or abuse committed against the Organization.
• Participate in formulating and implementing a comprehensive Fraud Risk Management framework within the Retail Segment.   
• Applying theories, concepts and approaches relevant to administrative investigations.
• Applying various research methodologies and sources as required in investigations, including using electronic sources on the Internet, intranet and other databases. 
• Reporting fraud cases to IRA or Police to facilitate prosecution of agents, staff or other Britam stakeholders involved in fraudulent business practices and giving evidence in Court.
• Maintaining a database of cases received and regularly and assist in preparation of Management, Board and other relevant reports and statistics as required.
• Propose, discuss and agree recommendations to improve control weaknesses identified during investigations and regularly follow up for their implementation.
• Managing and strengthening bonds with law enforcement agencies and other Industry & non-industry players to enhance co-operation on mutually beneficial information, fraud investigations, asset tracing & recovery etc.
• Conducting anti-fraud awareness training to various stakeholders.

Key Performance Measures:

As described in your Personal Scorecard.

Knowledge, experience and qualifications required:

• A degree from a recognized university.
• Certified Fraud Examiner (or equivalent).
• 4 years’ experience in criminal or administrative investigations; preferably in the insurance industry.
• Knowledge of business operations, fraud investigations, prosecution process including preparation of evidence.
• Knowledge of theories, concepts and approaches relevant to criminal and administrative investigations. 
• Knowledge of various research methodologies and sources, including electronic sources on the Internet, intranet and other databases.

Technical/ Functional competencies:

• Knowledge of insurance regulatory requirements.
• Knowledge of insurance products.
• Sales and marketing management skills.

Leadership category responsibility framework (Core Competencies):

Team Leader Competency Descriptions.

• Leading and Supervising - Provides team with a clear direction based on the overall strategy and objectives of the department; motivates and empowers others with a clear sense of purpose; creates a positive climate that fosters learning and development; acknowledges high potential talent within the team; sets and articulates the departmental strategy and organizational values through own personal behaviour.
• Adhering to Principles and Values - Upholds and encourages ethical behaviour and departmental values; demonstrates integrity; encourages team and individual responsibility towards the community and the environment; models the organizational values during every day interactions.
• Analyzing - Analyses numerical data and all other sources of information, breaking them into component parts, patterns and relationships; probes for further information or greater understanding of a problem; makes rational judgements from the available information and analysis; demonstrates an understanding of how one issue in the team or department may be a part of a much larger system / issue in the organization.
• Planning and Organizing - Sets clearly defined team objectives; plans activities and projects well in advance and takes account of possible changing circumstances; identifies and organizes resources needed to accomplish tasks, projects and team objectives; manages time effectively; monitors team performance against deadlines and milestones.
• Delivering Results and Meeting Customer Expectations - Focuses on customer needs and satisfaction; sets high standards for quality and quantity; monitors and maintains quality and productivity; works in a systematic methodical and orderly way; consistently achieves project and team goals.
• Deciding and Initiating Action - Ensures team objectives are met; takes responsibility for decisions, actions, projects and people while focusing on the achievement of team results; takes initiative and works under own direction; initiates and generates activity; makes quick, clear decisions with all information available; team decisions and actions take into account possible impact on all parts of the department.
• Relating and Networking - Easily establishes, as well as assists others in building meaningful relationships with customers and staff; relates well to people at all levels in the department; builds effective networks within, as well as outside the department; facilitates the resolutions of conflict and manages disagreements within team with tact and diplomacy.
• Persuading and Influencing - Gains clear agreement and commitment from team members; promotes the departmental strategy and objectives during team conversations; promotes ideas on behalf of the team and / or department; takes care to manage the team’s impression and brand on others.
• Creating and Innovating - Produces new ideas, approaches, and insights; facilitates the creation of innovative products or designs; produces a range of solutions to problems.
• Formulating Strategies and Concepts - Works strategically to realize team goals; understands and effectively communicates the departmental strategy; translates the departmental strategy and vision into operational responsibilities; takes into consideration departmental strategy during all tasks, projects and decision-making; takes account of a wide range of issues across, and related to the team.
• Working with People - Shows respect for the views and contributions of team members; shows empathy; listens, supports and cares for others; consults others and proactively shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
• Presenting and Communicating Information - Speaks fluently; expresses team objectives, opinions, information and key points of an argument clearly; responds quickly to the needs of the team and to their reactions and feedback when communicating; projects credibility.

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