Fraud & Investigation - Compliance

Job Description
A
Position Overview
Position Title
Department
Band
Assistant Manager
Compliance Fraud Monitoring Unit
301
B
Organizational Relationships
Reports to
Direct
Associate Vice President Fraud Monitoring Unit
Supervises
Investigations, Data Analytics, Central Co-ordination
Reporting
&
C
Job Dimensions
Geographic Area
Covered
PAN India
Stakeholders Internal
Operations (All teams), Front Line sales employees, Agents,
Audit, Regulatory Compliance, Risk Management Office,
Finance and Accounts
Stakeholders External
Customers, Vendors, Field Investigators, AIA Group
D
Key Result Areas
Investigations & Case
Management

Conduct investigations related to sales misconduct,
customer complaints, early claims, and other sourcing
malpractice including fraud, mis-selling, document
forgery, and non-disclosure, Whistleblower complaints
including internal frauds.

¢
Handle employee and agent-related investigations
across pre-issuance, post-issuance, and claims stages.
Conduct interviews with employees, agents, and
relevant stakeholders, ensuring professional, unbiased,
and defensible fact-finding.
¢
¢
Analyze policy-level data, submission patterns,
persistency trends, cancellation ratios, and claim
linkages to establish employee / agent accountability or
collusion
Support investigations involving suspected nexus fraud

between employees, agents, vendors, or external
parties.
Data Analysis & Control
Assessment
¢
Conduct in-depth data analysis using Excel, dashboards,
or analytics tools to identify trends, outliers, and red
flags.
¢
¢
Identify process weaknesses and control gaps leading to
misconduct or fraud.
Work with stakeholders in developing a root-cause
analysis and recommend/agree on suitable corrective
and preventive measures.
Stakeholder
Coordination
¢
Coordinate with Claims, Underwriting, Sales, HR, Legal,
Risk, and Operations teams for investigation inputs and
case closure.
¢
¢
Follow up on end-to-end closure of cases, including
disciplinary actions, process fixes, or policy changes.
Support internal and external audits, regulatory
reviews, and management reporting related to fraud
and market conduct cases.
Documentation &
Reporting
¢
Prepare clear, structured investigation reports with
evidence, observations, conclusions, and
recommendations.
¢
¢
¢
Maintain accurate case records aligned to internal
governance standards and regulatory expectations.
Track case metrics, aging, and outcomes for periodic MIS
and dashboards.
Assist in special projects related to process reviews,
regulatory preparedness, control testing, or thematic
conduct risk assessments.
Project Management
¢
¢
Translate investigation outcomes and analytics into
actionable insights, recommending corrective and
preventive measures including process changes, control
enhancements, and targeted interventions.
Partner with Zonal and Regional Sales Leadership to
Building Ethical Culture
reinforce ethical selling practices, fair customer outcomes,

and adherence to company policies and regulatory
expectations.
¢
Drive a culture of ethical conduct and joint accountability,
enabling business leaders to own conduct risks alongside
Compliance and Market Conduct teams.
E
Skills Required
Excellent Knowledge of MS- Excel, Word, Power-Point, Drafting Skills
Technical
Level 1
OK
Level 2
Level 3
Behavioral *
Interpersonal skills
Communication skills
Teamwork Skills
OK
OK
Ok
Decision making skills
Incumbent Characteristics
Essential
Desired
Graduation in any field MBA, CA, LLB
Qualification
Experience
Prior work experience
in Audit, Compliance,
Risk Management,
Anti-Fraud, Risk
Knowledge of AML, Infosec Guidelines,
Certified Fraud Examiner (CFE)
Control Units, Claims
Investigations, Service
Assurance etc.