The Fraud Investigation and Engagement Processes

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Presentation transcript:

The Fraud Investigation and Engagement Processes 07 The Fraud Investigation and Engagement Processes McGraw-Hill/Irwin Copyright © 2012 by The McGraw-Hill Companies, Inc. All rights reserved.

The Fraud Investigation Process The fraud investigation process involves systematically gathering and reviewing evidence for the purpose of documenting the presence or absence of fraud.

The Fraud Investigation Process The engagement process: the series of steps that begins with the investigator’s first contact with the case and concludes with a complete agreement regarding the fraud investigation. The evidence collection process: the various steps in which evidence in support of the objectives and scope of the investigation is collected. The Fraud Theory Approach to Evidence Collection

Four Types of Evidence

The Fraud Engagement Process The fraud engagement process begins with the investigator’s first contact with the case and ends with a complete agreement regarding the services the fraud investigator will provide.

The Incident Report Includes the initial information used to justify the investigation The initial information should be included in a unified case file The incident report can serve as probable cause for law enforcement The incident report can provide proof that the suspect is not being singled out because of illegal discrimination or in violation of collective bargaining rights

Consider Legal Issues Consider rights of workers or other suspects Consider the possibility of conducting the investigation under attorney-client privilege Evaluate the evidence and consider whether there is sufficient legal justification to fire a worker or place a worker on administrative leave Consider the rights of investigating employers Consider the extent to which a government entity might be involved in the investigation Consider reporting obligations

Evaluate Loss Mitigation and Recovery Considerations Immediate Loss mitigation options: (1) immediately fire the employee, (2) change the employee’s job responsibilities, (3) place the employee on administrative leave (with or without pay), or (4) permit the employee to continue in her current position, possibly continuing the fraud, thus giving the investigator the possibility of catching her in the act. Insurance recovery Recovery through litigation The objectives, scope, and costs of the investigation

Possible Objectives for an Investigation Stop the fraud from continuing. Identify the loss for insurance purposes. Identify the loss for tax purposes. Make an example of a fraudster. Minimize any embarrassing disclosures in the press. Discover weaknesses in the internal control system.