The Fraud Investigator conducts investigations and reports suspected instances of insurance fraud. They review and research evidence and documents to analyze the overall fact pattern of claim and synthesis data into professional reports with recommendations.
Duties & Responsibilities:
- Conduct investigations in accordance with company, SIU, statutory, regulatory, and other legal guidelines.
- Identify leads and potential investigations from data, databases, and/or spreadsheets.
- Give regular, timely, and accurate written reports to the referring party in accordance with New York State regulation and company policies.
- Conduct interviews and take recorded or written statements.
- Verify receipts, complete activity checks, and other investigative processes with SIU resource materials such as cameras, computers, and recorders.
- Maintain chronological case order.
- Report all suspected instances of insurance fraud in accordance with regulations.
- Testify in court.
- Brief management.
- Maintains an accurate factual log of activities on all files.
- Regularly interface with law enforcement or regulatory agencies.
- Regular liaison between SIU Field Investigators, EFW Examiners, and Claims Examiners.
- Maintain technical proficiency with SIU resource materials i.e., cameras, computers, recorders, etc.
- Remain current in insurance investigative techniques and knowledge through course and training module as assigned.
- Remain familiar with civil law, criminal law, and all other laws that may impact an investigation or how to deal with the results.
- Other duties as assigned.
Requirements:
- Associate or bachelor's degree in criminal justice or related field, OR five years of insurance claims investigation experience, OR professional investigation experience with law enforcement agencies, OR seven years of professional investigation experience involving economic or insurance related matters.
Skills & Qualifications:
- Working knowledge of New York State regulations and company policies.
- Familiar with civil and criminal law and all other laws that may impact an investigation or results.
- Technical proficiency with cameras, computers, recorders, and all SIU resource materials.
- Good computer skills including electronic email and databases.
- Proficient Microsoft Word and Excel skills.
- Organized; detail oriented; investigative thought process.
- Excellent communication skills including verbal and written and active listening.
- Ability to work independently and take direction.
- Ability to analyze data to identify leads and potential investigations.
- Ability to at times work in less-than-ideal situations and locations while performing investigations.
Market Range: 6 / 40 hours per week / Hybrid- 2 days in office
Salary: $48,476- $75,407
Accepting applications through: 10/27/26
Equal Opportunity EmployerThis employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Skills Required
- Associate or bachelor's degree in criminal justice or a related field
- Five years of insurance claims investigation experience, or professional investigation experience with law enforcement agencies, or seven years of professional investigation experience involving economic or insurance-related matters
- Working knowledge of New York State regulations and company policies
- Familiarity with civil, criminal, and other laws affecting investigations
- Technical proficiency with cameras, computers, recorders, and SIU resource materials
- Computer skills, including electronic email and databases
- Proficiency with Microsoft Word and Excel
- Ability to analyze data to identify leads and potential investigations
- Excellent verbal and written communication and active listening skills
- Ability to work independently and take direction
- Ability to work in less-than-ideal situations and locations while conducting investigations
What We Do
NYCM Insurance is a property and casualty insurance carrier that has been providing coverage to residents and businesses in New York since 1899. With a team of over 975 employees, and a network of over 1,400 independent agents, NYCM is dedicated to providing superior service and a quality customer experience. Our story began in Edmeston, NY – a tiny rural town known for its agricultural community – when one farmer lost everything in a fire. Realizing that the town needed to be better prepared for the future, 27 businessmen and residents came together to pool money and protect one another from fires and lightning, officially establishing the New York Central Mutual Fire Insurance Company under founder VanNess D. Robinson in 1899. We are a family founded and run company and believe in staying true to our small-town roots. Over 120 years later, we’re still operating in our original town of Edmeston, NY and have expanded to include three additional offices in Sherburne, Orchard Park and Canajoharie, further investing ourselves in New York State and our local communities. We are also highly invested in our 900+ employees. We know that our best work comes from an inspired internal culture and our drive to succeed as a team. Between our employee base and a network of over 1,200 independent agents, NYCM Insurance is proud to service over 525,000 insureds. Our insurance lines include Home, Auto, Umbrella, Commercial and more. NYCM Insurance is proud to work with various partners to offer additional types of coverage for many areas of your life including special events, motorcycles, off-road vehicles, bicycles, yachts, collector cars and more. These partnerships help us ensure that you and yours are always protected no matter what life throws at you. At the end of the day, our reason for doing business is the same as it was 120 years ago. We believe in providing genuine care; so that we can all have hope for a better tomorrow and the courage to persevere.
