Job Description
Co-op Life Insurance Limited is a growing life insurance company committed to providing reliable and customer-focused insurance solutions while maintaining strong standards of professionalism, integrity, and regulatory compliance.
Cooplife Insurance Limited is seeking an experienced and highly competent Head of Investigation to lead the Company's investigation function and ensure that suspected fraudulent claims, irregularities, misconduct and other matters requiring investigation are handled independently, professionally and confidentially.
Head of Investigation
Job Responsibilities
- Lead and manage the Investigation Department and establish effective investigation standards and procedures.
- Conduct and supervise investigations into suspected fraudulent, irregular or suspicious insurance claims and activities.
- Investigate suspected misrepresentation, non-disclosure, forged documentation, identity-related issues, agent misconduct and other insurance-related irregularities.
- Review investigation referrals from Claims, Underwriting, Compliance, Operations and other departments and determine appropriate investigative action.
- Conduct interviews and obtain, verify and analyse documentary, digital and third-party evidence.
- Coordinate with relevant external parties, including government institutions, medical professionals, law-enforcement authorities, external investigators and legal advisers, where required.
- Prepare comprehensive investigation reports setting out the facts, evidence, findings, risks and recommended actions.
- Present significant investigation findings and recommendations to senior management and relevant committees.
- Identify emerging fraud trends and recommend improvements to claims, underwriting and operational controls.
- Ensure all investigations are conducted with independence, impartiality, confidentiality and due process.
- Ensure compliance with applicable insurance laws, regulatory requirements, company policies and investigation procedures.
- Lead, coach and develop investigation staff and monitor departmental performance and investigation turnaround times.
- Maintain proper investigation records and ensure the security and confidentiality of sensitive information.
Qualifications & Requirements
- Bachelor's Degree in Insurance, Finance, Accounting, Business Management, Law or a related field
- Professional qualification in Insurance is preferred
- A professional qualification in Fraud Examination, Risk Management, Compliance, Internal Audit or Forensic Accounting will be an added advantage
- 8-10 years of relevant experience in the life insurance industry, with strong exposure to claims, investigations, fraud detection or underwriting
- Proven experience in investigating life insurance claims, particularly death claims and suspected fraudulent or irregular claims
- Experience in leading and managing an investigation team
- Sound knowledge of life insurance products, policy conditions, claims procedures and regulatory requirements
- Strong analytical, investigative, interviewing and report-writing skills
- Willingness to travel outstation, if and when required, to conduct investigations
- High level of integrity, confidentiality, independence and professional judgement
- Excellent communication skills in English; proficiency in Sinhala and/or Tamil will be an advantage
Interested candidates are invited to forward their CVs with contact details to [email protected] or by registered post within 14 days of the publication of this advertisement.
No. 455, Galle Road, Colombo 03.
