Senior Claims Investigation Specialist

🏗 We're Hiring: Senior Claims Investigation Specialist
📍 Location: United Arab Emirates (Remote)
🕒 Employment Type: Full-Time
💼 Experience Level: Mid-Level to Senior
🌐 Work Arrangement: Fully Remote
About Us
We are a construction-focused organization committed to delivering complex projects through disciplined risk management, commercial accountability, operational transparency, and effective governance. Our teams collaborate across Project Management, Construction, Engineering, Procurement, Commercial, Legal, Finance, Human Resources, Design, Quality, HSE, Consultants, Contractors, Suppliers, Logistics, Administration, Information Technology, and Executive Leadership.
We understand that effective claims investigations are essential to protecting organizational assets, identifying the facts behind reported losses, resolving disputed claims, preventing financial leakage, and strengthening internal controls. We promote evidence-based decision-making, procedural fairness, confidentiality, professional integrity, and continuous improvement across all business operations.
The Role
We are seeking an experienced Senior Claims Investigation Specialist to investigate complex, disputed, suspicious, or high-value claims involving insurance losses, construction incidents, property damage, contractual disputes, financial discrepancies, third-party liabilities, and other business-related exposures.
The successful candidate will develop investigation plans, collect and assess evidence, conduct interviews, analyze documents and financial records, identify inconsistencies, evaluate claim circumstances, and prepare comprehensive investigation reports. The role will collaborate closely with Claims Management, Risk Management, Legal, Finance, Commercial, HSE, Project Management, Procurement, insurers, brokers, loss adjusters, and other relevant stakeholders.
The ideal candidate will have strong investigative judgment, analytical capabilities, knowledge of claims assessment, and experience working with complex documentation and disputed facts. The specialist must maintain objectivity, protect confidential information, preserve evidence appropriately, and ensure that conclusions are supported by verifiable facts rather than assumptions.
Key Responsibilities1. Claims Investigation and Case Management
Lead investigations into complex, disputed, high-value, unusual, or potentially fraudulent claims affecting the organization.
Review new claims to establish their nature, circumstances, financial exposure, urgency, and investigative requirements.
Develop structured investigation plans identifying key questions, evidence sources, relevant stakeholders, investigative procedures, and expected outcomes.
Establish investigation objectives, milestones, timelines, reporting requirements, and escalation procedures.
Assess whether claims are supported by credible, consistent, and sufficient documentation.
Identify discrepancies between reported events, supporting evidence, financial records, contractual obligations, and other available information.
Determine whether additional investigation is required before a claim can be assessed, settled, challenged, or referred for specialist review.
Coordinate multiple investigations while prioritizing material exposures, urgent cases, and time-sensitive policy or contractual deadlines.
Maintain accurate investigation registers documenting case status, activities, findings, outstanding information, and recommended actions.
Monitor investigation progress and ensure outstanding requests, interviews, reviews, and assessments are completed within agreed timeframes.
Escalate material findings, potential misconduct, suspicious circumstances, and significant financial exposures through authorized channels.
Ensure investigation activities comply with internal procedures, applicable laws, contractual obligations, and relevant insurance requirements.
2. Evidence Collection and Preservation
Identify, collect, organize, and assess evidence relevant to reported claims, incidents, losses, and disputes.
Obtain incident reports, photographs, videos, witness statements, correspondence, inspection reports, invoices, quotations, contracts, and other supporting documentation.
Coordinate the collection of project records, construction logs, delivery notes, equipment records, procurement documents, maintenance histories, and financial transactions.
Establish a clear chronology of events using verified records, statements, timestamps, and other reliable evidence.
Assess the authenticity, relevance, consistency, completeness, and reliability of available evidence.
Identify missing records, unexplained alterations, inconsistent dates, duplicate documents, and other potential evidential concerns.
Maintain appropriate evidence registers, document references, source records, and chain-of-custody documentation where required.
Preserve original records and ensure that evidence is handled, transferred, stored, and accessed in accordance with applicable procedures.
Coordinate with Information Technology and authorized forensic specialists when electronic records or digital evidence require examination.
Ensure evidence collection respects privacy, confidentiality, access restrictions, and applicable legal requirements.
Document limitations in evidence availability and explain how these limitations affect investigative conclusions.
Prepare organized evidence packages to support claims decisions, settlement discussions, legal reviews, audits, and formal proceedings.
3. Interviews and Fact-Finding
Conduct structured interviews with claimants, employees, witnesses, contractors, suppliers, project personnel, and other relevant individuals.
Prepare interview plans and questions tailored to the circumstances, disputed facts, and evidence requirements of each case.
Obtain clear accounts of incidents, reported losses, decisions, communications, and relevant activities.
Compare interview statements with documentary evidence and other available accounts.
Identify inconsistencies, omissions, conflicting explanations, and areas requiring further clarification.
Conduct interviews professionally, impartially, and respectfully, without coercion or inappropriate pressure.
Maintain accurate interview notes and records in accordance with approved procedures and applicable requirements.
Arrange follow-up interviews when material facts remain unclear or new evidence becomes available.
Coordinate with Human Resources and Legal when investigations involve employee conduct, sensitive workplace matters, or potential disciplinary implications.
Ensure interview records distinguish direct observations, personal recollections, second-hand information, and unverified allegations.
Protect the confidentiality of interview participants and restrict disclosure of sensitive information to authorized parties.
Escalate matters requiring specialist legal, forensic, technical, or regulatory investigation.
4. Insurance Claims Verification
Investigate insurance claims involving property damage, equipment loss, construction incidents, cargo damage, motor accidents, liability allegations, and other insured exposures.
Review relevant policy wording, schedules, endorsements, exclusions, deductibles, notification conditions, and coverage limits.
Assess whether the reported circumstances are consistent with the available evidence and the apparent scope of the relevant insurance policy.
Verify the circumstances, timing, location, cause, and reported extent of insured losses.
Compare claimed amounts with supporting invoices, repair estimates, asset records, purchase documents, and independent assessments.
Identify discrepancies between the reported loss and the evidence supporting the amount claimed.
Investigate repeated, unusual, inconsistent, or inadequately substantiated claims.
Coordinate with insurers, brokers, loss adjusters, surveyors, and technical experts to obtain relevant findings.
Review independent assessment reports and identify unsupported assumptions, unexplained differences, or areas requiring clarification.
Distinguish factual investigation findings from policy interpretation and coverage decisions reserved for authorized insurers or legal advisers.
Prepare evidence-based recommendations concerning claim verification, further investigation, settlement review, or referral to appropriate specialists.
Maintain accurate records of insurer requests, investigation responses, findings, and outstanding matters.
5. Fraud Indicators and Irregularity Detection
Identify indicators of potential insurance fraud, claim inflation, document manipulation, duplicate claims, misrepresentation, collusion, or other irregularities.
Analyze inconsistencies in incident descriptions, timelines, witness statements, financial documentation, and reported loss calculations.
Review repeated claims, unusual claim patterns, unexplained asset losses, and transactions requiring additional scrutiny.
Identify potential conflicts of interest, suspicious supplier relationships, questionable invoices, or irregular repair and replacement costs.
Examine whether supporting documentation appears inconsistent with physical evidence, operational records, or established business processes.
Use approved analytical methods to identify unusual patterns across claims data, historical incidents, and financial recor

Work arrangement
Yes