MiWay Insurance Limited
What will you do?
The Merit Desktop Investigator plays a critical role in safeguarding the insurer from fraudulent, inflated, or misrepresented claims through effective desktop-based investigation.
This role requires strong analytical acumen, attention to detail, and the ability to make well-supported merit decisions without the need for physical fieldwork. The incumbent will evaluate commercial and personal lines claims to ensure validity, policy compliance, and fairness to all parties.
What will make you successful in this role?
Minimum Qualification Required
Grade 12 / SAQA Accredited Equivalent
Mechanical Engineering / Panel beating N2/ N3 level
Minimum Experience
2 – 4 years’ work experience in the following
Workshop / Motor Industry experience
Front line / client relationship experience in a panel beating environment.
Practical panel beating, spray painting, mechanical and electrical experience.
Assessing experience at a short-term insurer
Estimating in a panel beating environment
Deliverables include, but will not be limited to
Conduct detailed desktop-based merit assessments of claims across personal and commercial lines, identifying red flags or anomalies.
Analyse policy wording, claims documentation, incident details, and supporting evidence to determine the validity of the claim.
Engage with claimants, brokers, service providers, internal assessors, and third parties via phone, email, and digital platforms to gather required information.
Draft clear, defensible, and objective investigative reports with recommendations on repudiation, settlement, or escalation.
Identify potential fraud indicators and refer or escalate complex matters to field investigators or the Forensic Team.
Liaise with legal, underwriting, or recoveries departments where needed to finalise the claim outcome.
Maintain accurate and detailed records on all investigations using case management tools or claim systems.
Stay up to date with insurance fraud trends, regulatory frameworks, and investigative best practices.
Contribute to fraud prevention strategies by identifying modus operandi, and suggesting control enhancements.
Competencies Required
Analytical Thinking
Attention to Detail
Ethical Judgement & Integrity
Decision-Making Ability
Communication Skills
Problem Solving
Accountability & Ownership
Collaboration
Resilience
Qualification and Experience
Preferably a qualified panel beater with specialised knowledge to accurately assess damage.
Knowledge and Skills
Automotive Damage Claims
Claims Management
Claims Reporting
Claims approvals and rejections
Claims settlements
Deadline to apply: 22 October 2025.
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