Job Description

Why CIG?

At Capital Insurance Group we offer our employees more than just a job. We foster career growth, provide opportunities to give back to our communities, and help you take the next step in your career!

CIG was founded in 1898 by a group of earnest farmers in need of protection and today, we are the leading West Coast Property & Casualty insurer. CIG is certified as a Great Place to Work and provides a collaborative, inclusive, and fun work culture for all employees.

Why choose CIG’s Claim’s Team?

CIG claims department is here to support our insureds throughout their claims process. We work directly with our agency partners and policyholders to accomplish successful claim resolutions. Join the claims operation and you can be part of a team who provides excellent service, build relationships, and achieves successful outcomes for our clients.

Benefits

• Accrue twenty-one days of Paid Time Off during your first year
• Up to eighty-seven percent of benefits covered by CIG for you and your family members
  • Medical, dental, vision plans
• One hundred percent covered plans
  • Basic Life & AD&D
  • Employee Assistance
  • Leave Management
  • Long Term Disability
  • Short Term Disability (Outside of CA)

• Family Caregiver Support (Homethrive)
• Child Care Resources (Tootris)
• Business Travel Accident Protection

• Voluntary benefit offerings
  • Short-term (CA only)
  • Voluntary Life AD&D self, spouse and child plans
  • Flexible Spending
  • Health Savings (HSA)
  • Hospital Indemnity
  • Accidental Injury

• Critical Illness
• ARAG Legal Services
• Norton LifeLock

• Nine paid holidays, plus two floating holidays
• Above and Beyond Reward Recognition Program
  • Kudos & Shout Out Points Program
  • Quarterly Above and Beyond Bonus Program
  • Annual Above and Beyond Bonus Program
• Competitive compensation
  • Base compensation
  • Salary Management Spot Bonuses
  • Annual Incentive/Profit sharing program, potential payout annually based on company results.
• Discount partnerships
  • Gym memberships, credit union, travel, shopping, restaurants, theme parks, and more
• Insurance Educational reimbursement and bonus programs
• Employee Referral Bonus Program
• You have a voice! You are encouraged to share your voice through multiple channels, get involved with our Employee Experience and DEI committees to drive and continue the health and wellbeing of our organization for everyone.
• Home and Auto Insurance Discount Program.
• Paid Volunteer Time – Through company planned community events and choose your own adventure PVT in giving back in ways that are meaningful to you!
• Retirement savings benefit (401k and Roth + match)
• Health & Financial Wellness
  • Wellness platform, tools and events
  • Health Savings Account – match
  • Financial Wellness Resources

Work Environment & Format:

The Special Investigative Unit (SIU) Manager is a hybrid-eligible position from one of our CIG offices in Washington, California, Arizona, and Nevada. Hybrid schedules involve working three days in the office (Monday through Wednesday) and two days from home (Thursday and Friday).

Job Overview:

The primary focus of this position is to lead the Company’s anti-fraud initiatives and to aggressively pursue, document, and provide sufficient evidence for the arrest and conviction of perpetrators of insurance fraud. The SIU Manager is responsible for the oversight of the SIU Investigator team and overall investigation of potentially fraudulent activities. Acts as the administrator of Verisk ISO products to ensure claims staff has the appropriate permission levels and provides training on use and interpretation of results. Works collaboratively with various claims handling roles by providing training on investigation strategies to include statement taking and evaluation of documents. Directly involved in statement taking and other investigative activities as warranted, including with the EUO processes where necessary.

Provides annual training and new hire onboarding training. Responsible for maintaining compliance with state regulatory requirements including DOI, NICB and OFAC. Works collaboratively with underwriting for fraud detection and prevention activities.

Responsibilities:

• Promotes fraud awareness and prevention across the organization.
• Responsible for the management and supervision of a team of 2+ SIU Investigators.
• Provides training and development of staff in the identification, investigation, and reporting of suspected fraudulent activities.
• Administers 90-day new hire training and annual training to all staff.
• Responsible for the development of investigation strategies; performs documentation for legal analysis; and assigns resources, as appropriate, for fraud investigations.
• Works closely with insurance regulators and outside third parties to track and monitor suspicious cases.
• Reviews claim reporting in ISO with special attention to scores over 650 and provides guidance for further investigation, undertaking direct investigation as warranted.
• Reviews exceptions identified from DOI reinspection and maintains appropriate reports.
• Files SIU compliance report with State DOI as required.
• Reviews OFAC and reports matches to Department of Treasury, ensuring payments are placed in blocked accounts and all relevant parties are notified.
• Responds to law enforcement agencies within 30 days from receipt of request.
• Files EFD1 forms when applicable.
• Manages Insurance Code section 791 requests between carriers.
• May be required to testify in depositions or trial.
• Job description is not prescriptive, but rather a guide as to the duties and responsibilities you will have, however it is not limited to the listed above.

Minimum Requirements:

• Requires comprehensive technical knowledge of property-casualty coverages and language.
• Knowledge of DOI regulations, legal concepts, and comprehension of contracts, case law, medical treatment and medical terminology.
• Must be results oriented and skilled in effective negotiation techniques and capable of the handling of complex claim files, independently.
• Must have excellent communications skills to express ideas, make effective presentations orally and in written fashion, and must be able to educate and mentor claims staff.
• College degree in business, risk management, law, or related discipline.
• 7-10 years of progressively challenging claim-adjusting experience, including three years of experience handling complex property/automobile/casualty losses.
• Experience in concurrent handling of litigated claim files as well as mediation/arbitration/trial participation is also preferred.
• Previous experience in law enforcement or fraud investigation is highly desirable.
• Professional designation and certifications (CPCU, NCFIA, SCFIA, IASIU, etc.) are recommended.
• Maintain a valid Driver's License and operate a vehicle.

Salary Range: $80,456 - $132,753

The salary range listed here has been provided to comply with local regulations and represents a potential base salary range for this role. Please note that actual salaries may vary within the range above or below, depending on experience and location. We look at compensation for each individual and base our offer on your unique qualifications, experience, and expected contributions. This position may also be eligible for other types of compensation in addition to base salary, such as benefits and bonus programs.

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