Investigative Consultant chez Massmutual

Investigative Consultant 

Investigations & SIU Team 

Full-Time 

Springfield, MA 

The Opportunity 

We are seeking a highly skilled Investigative Counsel to join our Special Investigations Unit (SIU). This dual-role position blends investigative expertise in insurance fraud with legal counsel responsibilities focused on contract disputes, policy rescission, and fraud-related litigation. The successful candidate will be a licensed attorney with deep experience in insurance law, investigations, and dispute resolution. 

The Team 

MassMutual’s Investigations Unit is a uniquely skilled team of anti-fraud professionals who autonomously protect MassMutual, our customer, and the financial services industry by completing unbiased investigation and consultations that enable our partners to reach sound conclusions.  We are responsible for investigating, reporting on, and assisting with the prevention and prosecution of known or suspected acts of fraud and other acts of misconduct or wrongdoing committed by or against the Company. 

The Impact  

Special Investigations Unit (SIU): 

• Lead investigations into suspected fraudulent claims, misrepresentations in policy applications, and other forms of insurance-related misconduct. 

• Collect and analyze evidence including claim files, underwriting documents, financial records, and digital communications. 

• Conduct interviews with claimants, agents, and internal subject matter experts and stakeholders. 

• Prepare comprehensive investigative reports and present findings to legal and executive teams. 

• Collaborate with law enforcement, regulatory agencies, and internal departments to support enforcement actions. 

Legal Counsel – Insurance Litigation & Dispute Resolution: 

• Provide legal guidance on matters involving policy interpretations and potential rescission of insurance policies due to material misrepresentation or fraud. 

• Draft and review legal settlement agreements, memoranda, pleadings, coverage opinions, and litigation strategy documents. 

• Represent the company in pre-litigation negotiations, mediations, administrative hearings and court proceedings. 

• Coordinate and manage external counsel on litigation involving contested claims, rescission actions, and bad faith allegations. 

• Proactively monitor and advise on legal developments in insurance fraud, contract law, and regulatory compliance. 

Minimum Qualifications  

• Juris Doctor (JD) from an accredited law school; active bar membership required. 

• 5+ years of experience in insurance investigations and litigation. 

Ideal Qualifications 

• Strong understanding of insurance contract law, fraud statutes, and rescission principles. 

• Demonstrated proficiency in technology-driven investigative methods, including digital evidence analysis, data mining, and the use of specialized investigative software 

• Proven ability to manage sensitive investigations and legal matters with discretion. 

• Excellent analytical, writing, and communication skills.  

• Experience in SIU operations or fraud detection within the insurance industry. 

• Familiarity with FINRA, state insurance regulations, and anti-fraud frameworks. 

• Background in civil litigation, particularly involving coverage disputes and policy rescission. 

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