Senior Insurance Fraud & Claims Investigation Specialist
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Job Description
Insurance fraud specialist analyzing claims evidence and reconstructing loss events for Gramian Consultancy’s AI training and evaluation projects. Producing evidence-based assessments of staged and fraudulent claims.
Responsibilities:
- Analyze digital claim evidence, including CCTV footage, dashcam recordings, scene photographs, witness statements, and engineering reports
- Identify inconsistencies, anomalies, and indicators that may suggest staged incidents or fraudulent claims
- Reconstruct accident and loss events using visual, technical, and documented evidence
- Assess the authenticity of reported incidents and evaluate potential causes of loss
- Prepare detailed, structured written assessments suitable for Special Investigation Unit (SIU) investigators, forensic engineers, and insurance professionals
- Explain investigative findings and support conclusions with clear, objective evidence
- Identify patterns associated with staged-loss incidents, suspicious claims, and potentially organized fraud schemes
- Review technical reports, visual evidence, and claim documentation for accuracy and consistency
- Contribute investigative insights and industry best practices to AI training and evaluation datasets
- Collaborate remotely with project stakeholders and provide professional feedback and clarifications
Requirements:
- Minimum 7 years of relevant professional experience in Special Investigations / Special Investigation Units (SIU), Insurance Fraud Detection, Claims Investigation, Forensic Engineering, or Fleet Safety Investigation or Review
- Demonstrated experience analyzing insurance claim evidence and evaluating incident authenticity and causation
- Strong ability to interpret visual evidence, technical reports, statements, and supporting documentation
- Experience identifying inconsistencies and potential indicators of staged-loss incidents or fraudulent activity
- Excellent analytical and critical-thinking skills
- Strong written communication skills, with the ability to produce detailed, evidence-based investigative reports
- Ability to work independently and communicate findings clearly in a remote environment
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