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Special investigations manager - claims fraud

London
Hiscox
Manager
€80,000 a year
Posted: 22 May
Offer description

London Market Special Investigations Manager – Group Claims Fraud

Reporting to: Group Head of Fraud – Group Claims CoE

Location: London - Hybrid (min 2 days in the office per week)


Overview

The SIU Manager – London Market is accountable for leading and embedding an effective Special Investigations Unit capability across London Market claims. The role is responsible for the oversight, direction, and delivery of fraud investigation activity, ensuring suspected fraudulent claims are identified early, investigated thoroughly, and managed in line with regulatory, legal, and market expectations. The role plays a critical part in strengthening fraud resilience across complex, high‑value, and multi‑jurisdictional London Market claims, while working closely with Claims, Underwriting, Legal, Compliance, and external partners to drive consistent, high‑quality outcomes. The successful candidate will be responsible for identifying and investigating claims fraud risks across Group and multiple lines of business, ranging from SME to large corporate policies, by leveraging enriched data sources, advanced analytics, and emerging technologies.

You’ll work closely with underwriting, claims, and data science teams to develop fraud indicators, refine detection models, and embed fraud controls into core systems and workflows. This is a hands‑on, high‑impact role that offers the opportunity to shape future capabilities, influence strategic decisions, and contribute to a culture of integrity and vigilance across the organisation. You will be interacting with Senior stakeholders across the organisation, influencing others and critical thinking will be key to overcoming challenges.


Key Responsibilities

* Lead and manage London Market SIU activity, ensuring timely, proportionate, and effective investigation of suspected fraudulent claims
* Oversee SIU case triage, allocation, and prioritisation in line with fraud risk, claim value, and complexity
* Maintain oversight of SIU workload, capacity, and investigation quality across internal teams and third‑party providers
* Lead the identification and investigation of complex fraud typologies relevant to London Market business, including multi‑party, cross‑border, and organised fraud risks
* Develop and embed fraud indicators and investigative approaches aligned to London Market classes and claims profiles
* Support the continuous improvement of fraud detection, referral, and investigation processes across Claims
* Act as the senior SIU point of contact for London Market Claims, Legal, Compliance, Underwriting, and senior leadership
* Build and maintain strong working relationships with external stakeholders including SIU vendors, law enforcement, regulators, market bodies, and industry counterparts
* Ensure SIU activity complies with regulatory requirements, fraud legislation, data protection standards, and internal governance frameworks
* Provide training and guidance to the London Market business units on fraud detection best practices
* Able to produce accurate, timely and relevant management reporting of the success of the counter fraud strategy


Candidate Profile

An experienced London Market fraud professional with a proven track record of leading and developing SIU operations within complex commercial insurance environments, recognised for sound judgement, strong investigative expertise, and the ability to influence senior stakeholders across Claims, Legal, Compliance, and Underwriting to deliver effective, proportionate, and compliant fraud outcomes across high‑value, multi‑jurisdictional, and operationally complex claims portfolios.


Desirable skills and experience

* Proven experience leading or managing an SIU or fraud investigation function within insurance covering London Market or specialty commercial lines
* Deep understanding of insurance fraud typologies, investigative techniques, and referral models relevant to complex and specialty risks
* Experience overseeing high‑value and complex claims investigations, including multi‑party, cross‑border, or organised fraud cases
* Strong working knowledge of regulatory and legal frameworks relating to insurance fraud, data protection, and claims handling
* Demonstrable experience managing third‑party SIU vendors, including performance oversight, quality assurance, and cost control
* Ability to interpret and use fraud data, MI, and analytics to support investigation strategy and decision‑making
* Experience contributing to governance, audit, or regulatory reviews relating to fraud or claims controls
* Background in delivering or supporting fraud awareness and training for claims handlers and business stakeholders
* Professional fraud or investigation qualifications (e.g. CIFA, FCLS/FCLA, or equivalent)
* Ability to effectively communicate with all stakeholders across the business
* Able to prioritise and take ownership of tasks
* A team player who is also able to work independently to deliver in a fast‑paced environment
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