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Investigation of Insurance Claims imparts knowledge of good practices to investigators, surveyors and loss assessors, in-house surveyors, vigilance officers and advocates; who are engaged in an investigation for whatsoever reason. It provides case studies based on actual fraudulent claims for a practical understanding of the subject. The book covers: 1. Services provided by an insurance investigator, types of claims investigated, the investigative approach, incident analysis methods, good practices for insurance investigation, applicable provisions of law, kinds of fraud and case studies. 2. The duty and responsibility of surveyors, loss assessors and advocates to point out suspicious circumstances which need expert investigation.
The US Department of Justice's National Institute of Justice (NIJ) asked the Institute of Medicine (IOM) of The National Academies to conduct a workshop that would examine the interface of the medicolegal death investigation system and the criminal justice system. NIJ was particularly interested in a workshop in which speakers would highlight not only the status and needs of the medicolegal death investigation system as currently administered by medical examiners and coroners but also its potential to meet emerging issues facing contemporary society in America. Additionally, the workshop was to highlight priority areas for a potential IOM study on this topic. To achieve those goals, IOM constituted the Committee for the Workshop on the Medicolegal Death Investigation System, which developed a workshop that focused on the role of the medical examiner and coroner death investigation system and its promise for improving both the criminal justice system and the public health and health care systems, and their ability to respond to terrorist threats and events. Six panels were formed to highlight different aspects of the medicolegal death investigation system, including ways to improve it and expand it beyond its traditional response and meet growing demands and challenges. This report summarizes the Workshop presentations and discussions that followed them.
Unique insights into the nature of fraud and how to expose it It's not enough to wait for a tip to expose corporate fraud. Fraud 101, Second Edition provides step-by-step guidance on how to perform detection procedures for every major type of fraud. Its new and detailed case studies reveal how easy it can be for a perpetrator to commit a fraud and how difficult it can be to prosecute. This new edition also offers expanded coverage of financial statement fraud, fraud-specific internal control, and Sarbanes-Oxley.
This open access Pivot demonstrates how a variety of technologies act as innovation catalysts within the banking and financial services sector. Traditional banks and financial services are under increasing competition from global IT companies such as Google, Apple, Amazon and PayPal whilst facing pressure from investors to reduce costs, increase agility and improve customer retention. Technologies such as blockchain, cloud computing, mobile technologies, big data analytics and social media therefore have perhaps more potential in this industry and area of business than any other. This book defines a fintech ecosystem for the 21st century, providing a state-of-the art review of current literature, suggesting avenues for new research and offering perspectives from business, technology and industry.
A fraud investigation is aimed at examining evidence to determine if a fraud occurred, how it happened, who was involved, and how much money was lost. Investigations occur in cases ranging from embezzlement, to falsification of financial statements, to suspicious insurance claims. Expert Fraud Investigation: A Step-by-Step Guide provides all the tools to conduct a fraud investigation, detailing when and how to investigate. This guide takes the professional from the point of opening an investigation, selecting a team, gathering data, and through the entire investigation process. Business executives, auditors, and security professionals will benefit from this book, and companies will find this a useful tool for fighting fraud within their own organizations.
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.