Fraud Manager

The Fraud Management professional is responsible for preventing, detecting, investigating, and mitigating fraudulent activities across the life insurance business. This role ensures protection of company assets, policyholders, and brand reputation by implementing effective fraud controls, analytics, and investigation processes throughout the policy lifecycle.

Fraud Detection & Prevention

Identify, analyze, and investigate suspected or actual incidents of fraud/ suspected fraud involving internal policy violations or fraudulent activities related to proposals, underwriting, claims, servicing, and distribution.

Develop and implement fraud prevention strategies, red-flag indicators, and early warning systems.

Monitor high-risk transactions, claims, complaints agents, medical service providers, and third-party vendors.

Conduct Fraud risk assessment and Forensic audits

Create fraud training and awareness programs for Employees, agents, distribution channel and policy holders.

Investigations & Case Management

Conduct detailed fraud investigations, including document review, interviews, and field verifications.

Coordinate with internal teams (underwriting, claims, sales, legal) to gather evidence.

Prepare investigation reports and recommend appropriate actions.

Data Analytics & Reporting

Use data analytics, MIS, and dashboards to identify fraud patterns and emerging risks.

Track fraud trends, loss metrics, recovery amounts, and control effectiveness.

Present regular reports to senior management and risk committees.

Conduct meetings of Fraud monitoring committee (FMC) and support the FMC in discharging its function

Stakeholder & Regulatory Coordination

Liaise with law enforcement agencies, regulators, forensic experts, and external investigators when required.

Ensure compliance with regulatory guidelines, internal policies, and industry best practices related to fraud risk management.

Process Improvement & Training

Ability to prepare policies and process notes around fraud and related areas

Strengthen fraud control frameworks and standard operating procedures (SOPs).

Conduct fraud awareness training for employees, agents, and partners.

Support automation and technology initiatives for fraud detection and prevention.

Key Skills & Competencies

Strong knowledge of life insurance products, underwriting, and claims processes

Investigation and analytical skills

Understanding of fraud typologies and risk assessment

Data analysis and reporting (Excel, SQL, BI tools preferred)

Communication and stakeholder management

High ethical standards and attention to detail

Qualifications

Bachelors degree

Professional certifications in fraud/risk (e.g., CFE, CFI, AML) are an advantage

Experience

5 to 7 years of experience in fraud management, risk, Financial Crime, or compliance within life insurance or financial services (depending on role level)