SIU PIP Investigator

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. 

Job Description

This job is responsible for investigating and analyzing complex Michigan PIP claims that have been referred to the special investigation unit (SIU) for potential fraud. This role typically handles a combination of complex attorney represented and unrepresented claims and moderate to complex losses, in which suspicious activity has been identified. The individual performs a thorough investigation including; (1) conducting background searches, scene investigations, and clinic inspections; (2) taking recorded statements; (3) reviewing and analyzing medical notes, bills, and property damage; and (4) conducting witness interviews and social media searches. The individual conducts surveillance on property and/or creates scene reconstructions on some investigations and reviews whether fraud can be substantiated and supports a lawsuit. The individual provides work guidance and direction to less senior employees and provides mentoring and coaching to the team.

The ideal candidate is detail‑oriented, proactive, and adaptable, with the ability to manage multiple priorities in a fast‑paced environment. You bring a strong understanding of PIP regulations, demonstrate sound judgment, and consistently apply a thorough, analytical approach to claim investigations. Experience handling Michigan state PIP claims is highly desirable.

Key Responsibilities

• Enters SIU claim data information into multiple SIU systems

• Reviews investigations with fraud outcomes to validate whether denial is appropriate

• Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to MCO for further handling and settlement

• Conducts complex online data application searches, research, and evaluation

• Conducts complex site inspections, including body shops, medical clinics, loss locations etc.

• Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed

• Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads

• Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process

• Utilizes analytic tools or SIU field intelligence to identify complex claims for investigation and/or for support in the evidence of the fraud and damages

• Researches and responds to complex customer communications, concerns, conflicts or issues

Supervisory Responsibilities

• This job does not have supervisory duties.

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Skills

Analytical Thinking, Bodily Injury Claims, Decision Making, Fraud Analysis, Fraud Auditing, Fraud Investigations, Injury Treatment, Investigative Skills, Medical Record Reviews, Personal Injury Claims, Personal Injury Protection, Special Investigations

Compensation

Compensation offered for this role is 62,100.00 - 103,950.00 annually and is based on experience and qualifications.

The candidate(s) offered this position will be required to submit to a background investigation.

Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact.

Allstate generally does not sponsor individuals for employment-based visas for this position.

Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.

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Allstate provides a comprehensive technology setup, including a laptop, monitors, headset, keyboard, and mouse. Employees eligible to work from home also receive a monthly connectivity reimbursement to help offset internet costs.

When working from home, you must have a dedicated, private workspace free from distractions, along with appropriate desk and seating. Reliable internet is required, with minimum speeds of 50 MB download and 5 MB upload.