Lead, Claims Investigations

at  MLC Life Insurance

Are you committed to bringing your best to life every day?
At MLC Life Insurance, we’re proud of our history of protecting Australians for over 135 years. We provide flexible, affordable, and innovative insurance products to almost 1 million Australians. We’re Australian-led and managed, and part of a global network through our partnership with one of the world’s leading life insurers, Nippon Life Insurance Group.
We’re driven by a powerful purpose, providing our customers and their families with a Promise for Life to be there when they need us most – and that’s a great purpose to bring us together at work every day.
We work hard to deliver a total customer experience that keeps our customers and partners at the forefront of all our decisions. We’re a values-driven business that strives for high performance and growth as we look towards the future.

As we continue to strengthen our Claims function, we are establishing a new Claims Investigations & Support Services team to analyse, triage and support the claims team on matters of Non-Disclosure, Pre-Existing Conditions, Fraud, and financial matters.
A key member of this new team is the role of Lead, Claims Investigations, ideally based in Melbourne.
In this role your focus will be to evaluate the legitimacy of a claim where there has been doubt and ensure we are aware of and managing false or inflated claims. Using your investigative background and mindset you will make informed decisions and manage resources with the aim of prevention of occurrence and reduction of risk.

Your responsibilities will include:

• Consistently deliver high quality investigation services through a passion for high quality outcomes, teamwork and a focus on business efficiency.
• Prepare and produce accurate data and statements in a timely manner as well as reporting and audits.
• Develop, implement and roll out desktop surveillance protocols in line with our claims guidelines.
• Examine and assess all collateral: photographs, medical information, financial documents, audio or video surveillance to support with decision making.
• Coach and develop others through providing advice and on complex technical claims issues. Act as a point of reference with documentation of guidelines and procedures.