Monday, June 20, 2016

Welfare fraud investigation process in the welfare fraud cases

 Definition of Welfare fraud investigation process:


Welfare fraud investigation process in the welfare fraud cases is a methodology of resolving signs or allegations of fraud meaning from inception to disposition. The welfare fraud investigation process establishes a uniform, legal process for resolving signs or allegations of fraud meaning on a timely basis. It provides that welfare fraud cases should move in a linear order, from the general to the specific, gradually focusing on the perpetrator through an analysis of types of evidence in law.



welfare fraud cases

welfare fraud penalties

 Welfare fraud investigation process involve efforts to resolve allegations or signs of fraud meaning when the full facts are unknown or unclear; therefore, welfare fraud investigation process seek to obtain facts and types of evidence in law to help establish what happened, identify the responsible party, and provide recommendations where applicable.


When conducting a welfare fraud investigation process to resolve signs or allegations of fraud, the fraud examiner jobs should assume litigation will follow, act on predication, approach welfare fraud cases from two perspectives, move from the general to the specific, and use the fraud theory approach.


 Assume Litigation and welfare fraud penalties Will Follow:

Each welfare fraud investigation process should begin with the proposition that the case will end in litigation and welfare fraud penalties.
Thus, when a fraud examiner jobs begins a welfare fraud investigation process, he must assume that the welfare fraud cases will end in litigation, and this assumption must be maintained and considered throughout the entire welfare fraud cases. If the fraud examiner jobs assumes that litigation will occur with welfare fraud penalties, he will conduct the examination in accordance with the proper rules of types of evidence in law and remain well within the guidelines established by the legal systems.


 Act on predication definition:

Fraud examiner jobs must adhere to the law; therefore, fraud examiners should not conduct or continue welfare fraud investigation process without proper predication definition. Predication definition is the totality of circumstances that would lead a reasonable, professionally trained, and prudent individual to believe that a fraud meaning has occurred, is occurring, and/or will occur. In other words, predication definition is the basis upon which an examination, and each step taken during the welfare fraud investigation process, is commenced.

A fraud examiner jobs acts on predication definition when he has a sufficient basis and legitimate reason to take each step in a welfare fraud investigation process.

Accordingly, fraud examinerjobs should begin welfare fraud investigation process only when there are circumstances that suggest fraud meaning has occurred, and they should not investigate beyond the available predication definition. If a fraud examiner jobs can't articulate a factual basis or good reason for an investigative step and welfare fraud investigation process, he should not do it. Therefore, a fraud examiner jobs should reevaluate the predication definition as the fraud examination proceeds. That is, as a welfare fraud investigation process progresses and new information emerges, the fraud examiner jobs should continually reevaluate whether there is adequate predication definition to take each additional step in the examination of welfare fraud cases. If a fraud examiner jobs acts without predication definition, he might expose both himself and his client or employer to liability.


The requirement for predication definition, however, does not bar fraud examiners from accepting other forms of engagements in circumstances where predication definition is lacking. For example, a fraud examiner jobs can conduct a fraud risk assessment for consulting purposes even if there is no reason to believe a fraud meaning has occurred.


 Approach from Two Perspectives:

Fraud examiner jobs should approach welfare fraud investigation process into fraud meaning from two perspectives:

1/ by seeking to prove that welfare fraud cases has occurred;

2/ by seeking to prove that welfare fraud cases has not occurred.

To prove that a welfare fraud cases has occurred, the fraud examiner jobs must seek to prove that fraud has not occurred. The reverse is also true. To prove welfare fraud cases has not occurred, the fraud examiner jobs must seek to prove that fraud has occurred. The reasoning behind this two perspective approach is that both sides of welfare fraud cases must be examined because under the law, proof of welfare fraud cases must preclude any explanation other than guilt leading to the welfare fraud penalties.


 Move from the General to the Specific:

Fraud examiner jobs start when the full facts are unknown or unclear; therefore, they should proceed from the general to the specific. That is, welfare fraud investigation process should begin with general information that is known, starting at the periphery, and then move to the more specific details.

To illustrate, consider the order of interviews in welfare fraud investigation process. In most examinations, fraud examiner jobs should start interviewing at the periphery of all possible interview candidates and move towards the witnesses who appear more involved in the matters that are the probable subject will have welfare fraud penalties. Thus, the usual order of interviews is as follows:


Neutral third-party witnesses, starting with the least knowledgeable and moving to those who are more knowledgeable about the welfare fraud cases at issue;

Parties suspected of complicity and welfare fraud penalties, starting with the least culpable and moving to the most culpable;
The primary suspect(s) of the welfare fraud investigation process use the Fraud meaning.


Use the fraud Theory approach :

When conducting welfare fraud investigation process, fraud examiner jobs should adhere to the fraud theory approach. The welfare fraud cases approach is an investigative tool designed to help fraud examiners organize and direct welfare fraud investigation process based on the information available at the time.
The welfare fraud cases theory approach provides that, when conducting welfare fraud investigation process into allegations or signs of fraud occurring a welfare fraud penalties, the fraud examiner jobs should make a hypothesis (or theory) of what might have
Occurred based on the known facts. Once the fraud examiner jobs has created a hypothesis, he should test it through the acquisition of new information (or correcting and integrating known information) to determine whether the hypothesis is provable. If, after testing a hypothesis, the welfare fraud investigation process determines that it is not provable and they won’t have welfare fraud penalties, he should continually revise and test his theory based on the known facts until it is provable to apply the welfare fraud penalties, he concludes that no welfare fraud cases is present, or he finds that the fraud meaning can't be proven.
Simply put, the welfare fraud investigation process involves the following steps:
 
  • Forensic data analysis;
  • Creating a hypothesis about the welfare fraud investigation process;
  • Testing the hypothesis about the welfare fraud investigation process;
  • Refining and amending the hypothesis about the welfare fraud investigation process.
 

Forensic data analysis:

Under the welfare fraud investigation process, fraud investigator jobs should begin by forensic data analysis, so he can create a preliminary hypothesis as to what has occurred.
Also, if those responsible determined that a forensic audit jobs of the entire purchasing function is warranted, the forensic audit jobs would be conducted at the time this determination is made. When conducting the forensic audit jobs, the internal auditors should keep in mind that there is a possibility that fraud meaning might exist.
 

Creating a Hypothesis about the welfare fraud investigation process:

Once fraud investigator jobs has finished the forensic data analysis in the welfare fraud investigation process, he should create a preliminary hypothesis as to what has occurred. The hypothesis should be a "worst-case" scenario. That is, based on the caller's statements, fraud investigator jobs should determine the worst possible outcome. Under these facts, the worst possible outcome would be that one of boss’s purchasing agents has been accepting kickbacks to steer business to a particular vendor.
Welfare fraud investigation process can create hypotheses for any specific allegation (e.g., a bribery or kickback scheme, embezzlement examples, conflict of interest, fraud transactions, or financial statement fraud).
 

Testing the Hypothesis about the welfare fraud investigation process:

Once fraud investigator jobs has created a hypothesis, he should test it through the acquisition of new information or by correcting and integrating known information.
 
Testing a hypothesis in welfare fraud investigation process involves creating a "what-if" scenario.
Refining and Amending the Hypothesis about the welfare fraud investigation process:
If, after testing a hypothesis, the fraud examiner jobs in the welfare fraud investigation process, determines that it is not provable, the fraud examiner jobs should continually revise and test it based on the known facts. For example, if the fraud examiner tests his hypothesis and determines that the facts do not fit the presence of a bribery scheme, it could be that no fraud is present or that the fraud cannot be proven by the welfare fraud investigation process.

Abdo Mounir

About Abdo Mounir -

Senior Manager and fraud examiner in mining industry. Head the investigations related to fraud. My role includes driving the culture of integrity And ethics within the Company by conducting regular fraud investigations.

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