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Banking and Insurance Investigatiom

Durban, KwaZulu-Natal, South Africa
October 16, 2019

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*** ******** ****** *********, *****, Durban, 4052

M: 072-*******


ID: 841**********

Drivers: Code 08 with own car

Marital Status: Married

Dependents: Two


Please find enclosed my resume in relation to the aforementioned position. I am currently employed as a Forensic Investigator at Nedbank Group Financial Crime, Forensics and Security and seeking sponsorship for a Visa from a willing company.

I have been employed within the banking and insurance environment since 2004 and specifically been in the Forensics division for the last 7 years dealing with both banking and insurance fraud investigations.

These include investigations into the range of products administered by both the bank as well as the insurance division such as death, retrenchment, disability, critical illness, retrenchment, funeral as well as bank owned property claims.

I have developed a sound understanding of both the banking and insurance industry including an identification and prevention framework of the industry’s compliance. I naturally have an inquisitive and investigative mind with an eye for detail. I have exceptional written and oral communication skills and describe myself to be a diligent worker who is responsible, motivated and reliable. I have established a zeal to be effective by using logic and paying attention to detail with willingness and also adapt a holistic, strategic approach to risk management with the ultimate intention to mitigate the risks and/or fraud. Whilst performing my duties, I practice promoting and maintaining high ethical and reliable standards both personally as well as professionally and ensure that procedure is followed to the best of my ability in an honest manner.

I enjoy the stimulation and sense of achievement as well as being part of a team who works cooperatively with others to accomplish a common goal. Personal Attributes, Competencies & Legislative Compliance Client Focused / Tenacious FAIS Meticulous/ Problem Solver Risk Manager Interactive Skills FICA

Team player/ Peer



Self-Starter / Initiator /




Written communication Approachability

High service Ethic/ Priority


Bank Seta


Report writing/ telephone

skills & Time management

Technical Knowledge

( MS Office, 365

Professional Experience

Nedbank Group Forensic Services – Nov 2012 – to date (Current Employer) Forensic Insurance Investigator – Long and short-term insurance To Investigate and analyze all operational policy information to ensure validity,reduce fraud and identify risks by using a holistic approach for strategic risk management solutions. To conduct a thorough, complete investigations on matters reported from the group reporting line (whistle blower) in accordance with methodologies through process of elimination and information obtained from inspections and interviews. Specify and recommend control frameworks in managing risk, preventing and detecting irregularities of which fraud makes up the key component. Collect and analyze relevant information & identify modus operandi of the incident. Identify irregularities and involved part(ies) / syndicates; Probe problem areas by conducting interviews with internal & external witnesses and obtain affidavits. Network and liaise within the bank and externally (KZN Insurance Fraud Forum member and chairperson) resolving fraud issues; Consult with bank legal advisors and conveyancing attorneys where necessary; Consult with Prosecuting authority; Assess and pursue possible recovery prospects. Identify gaps in processes, make recommendations to improve processes after root cause analysis have been conducted and prevent re-occurrences as well as highlighting implications of not implementing recommendations so that corrective action can be taken. Ensure regulatory standards for recording keeping are met and compile research/investigation reports and submit to management and formulate a case docket with SAPS where applicable. Nedbank Insurance – October 2005 – January 2008 and March 2009 – Oct 2012 Claims Assessor & Complaints Champion

Accurately assessing life assurance claims. Researching and analyzing information using appropriate problem identification techniques in order to propose solutions. Examining coverage information and determining long/short term claim settlements on all Death claims for Life insurance policies, Funeral Policy payouts,Investment death claim payouts and Retrenchment claims on all universal insurance policies, credit life policies including loans, credit card and overdraft assurance. Resolving client complaint queries after reviewing the claims process followed in conjunction with the reason for the claim repudiation and recommending resolutions. USA - Receivable Management Services (R.M.S) August 2008 – March 2009 Chargeback Specialist

Analyzing credit card chargebacks and Retrieval disputes of Visa, MasterCard, Discover Network & American Express cards, conducting payee-verification services. Data is initiated by the various banks and captured into the RMS systems whereby decisions are determined on whether to reverse/dispute or accept and credit the chargeback to the cardholder. Boe Life Assurance – March 2004 – October 2005 Investment administrator/ Data Capturing clerk

Providing administration support to the claims and new business department, performing activities of an administrative nature including processing maturity investment payouts to clients of all matured policies. Customer Service - Dealing with all client queries, liaising with claimants, executors and Doctors for any outstanding claim requirements. Capturing personal information of all applications into the company’s system ie : new policies including homeloans, credit cards, overdrafts, Life and Investment Policy applications. Once Data is captured, information is utilized for tracking information, reporting and all client queries. Filing & General office duties. Qualification, Certifications and Competencies

• Certificate - Bytes Technology – Microsoft Outlook/ Microsoft 365

• Course- Nexus Training Academy – Report Writing

• Course - Nexus Training Academy – Interviewing, Interrogation and Forgery

• Certificate - Matric - Grade 12 – Senior Certificate

• Certificate/Course – Bank Seta Corporate Governance Unisa Bachelor of Arts : Criminology – NQF 7 - Law stream Criminology 1 & 2 / Law Skills / Administrative law / Reaction to Crime / Crime Risk Perspectives / Crime Prevention and Reduction / Research Methodology 1 / Criminal Law / Workplace English / Intro to Law / Law of Criminal Procedure : Pre-Trial / C&Y Misbehavior / Offending behavior / Selective Topics : Criminal Law ( white collar crime & Theft / Fundamental Rights / Family Law / Law of Evidence/ Formal Reaction to crime / Constitutional Law / Contemporary Criminological Issues / Victimology / Social Dimensions of Justice / Crime Typologies / Interpretation of Statutes / Law of Evidence / Labour Law

Diploma in Criminal Justice and Forensic Investigations UJ (NQF 5) Basic Criminal Law and specific Offences / Law of Evidence / Forensic Investigations / Basic Auditing Principles

Insurance – Long Term Category B - IISA ( NQF 5 – 36credits) - Life Insurance SAQA 76503 (NQF 5) Legal Framework of Insurance / Life Underwriting / Life Insurance Claims Unisa - Communication Science – (48 Credits)

Introduction to fundamentals of Communication / Persuasive Communication Skills (Public Speaking) English – Business Communication / English – (Business Literature & Writing) Damelin - Wealth Management (FAIS) – Banking and Insurance (NQF 4) Income Tax Act (58 of 1962 and the accompanying regulations) as amended as it applies to insurance and investment products / Demonstrate knowledge and insight into the Long-Term Insurance Act


Demonstrate knowledge and insight of the Financial Advisory and Intermediary Services Act (FAIS) (Act 37 of 2002)

Describe the basic principles of personal income tax / Describe the control of fraud in Long Term Insurance / Explain the Finance Intelligence Centre Act, Act 38 of 2001 and its implications for client Relations / Explain the nature of risk and the risk management process / Apply knowledge of statistics and probability to critically interrogate and effectively communicate findings on life related problems Apply knowledge of statistics and probability to critically interrogate and effectively communicate findings on life related problems / Represent analyse and calculate shape and motion in 2-and 3- dimensional space in different contexts Use mathematics to investigate and monitor the financial aspects of personal, business, national and international issues Public relations – Varsity College (Certificate)

The Nature of Public Relations and Communication / Planning of a Public Relations Programme / Special functions / Sponsorships / Media Liason / Printing, Audio Visual and Electronic mass media / Public Speaking


• Herman Fourie – Nedbank Group Forensics – 082-***-****

• Karen Muller – Nedgroup Insurance – 060-***-****

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