A fraud agent investigates suspected fraudulent activity for financial institutions such as banks or insurance companies. They review reports and may conduct field research or interviews to determine the legitimacy of a claim. The agent then files a final report with suggested actions, which may include contacting law enforcement.
A fraud agent’s responsibilities generally involve investigating cases or instances where a company or organization suspects that a fraudulent action may have taken place. This type of agent usually works for a financial institution such as a bank, insurance company or moneylender and reviews or investigates different reports. This usually starts with an overview of paperwork filed and claims made, but may require field research and investigation to observe people or conduct interviews. A fraud agent usually concludes a case by making a final report that is filed with your employer and indicates suggested actions.
One of the first actions of a fraud agent, sometimes called an investigator or officer, is to obtain and review cases of a fraudulent nature. For example, if an insurance company receives a claim from a customer, they can send paperwork to the agent. The agent reviews this data to determine its initial legitimacy, which may involve double-checking the basic information provided in the claim and ensuring that it is filled in correctly. At this early stage, a fraud agent may approve the documentation and pass it along, or decide that further investigation is needed.
As another example, a fraud agent working for an insurance company might decide that a claim looks suspicious and interview the person who filed it. Further research may include talking with medical or legal professionals involved with the person making the complaint and ensuring that the information provided by the complainant is legitimate and accurate. A fraud agent at a bank or money lending organization can verify references provided in documentation and perform a background check on someone. The exact nature of the research carried out during an investigation can vary depending on the nature of a case, but is generally done to determine the legitimacy of a claim.
Once a fraud agent has established that the documentation is accurate, he or she can provide further instructions to the employer. If the investigation does not reveal anything suspicious, the officer may recommend approval of a claim or loan. When searches or background checks indicate that there may be fraudulent activity, the agent is likely to instruct your employer to decline the claim. There are often legal ramifications that can occur when this type of fraud or abuse is encountered; therefore, a fraud agent may need to contact law enforcement professionals and provide them with the information they have collected.
Protect your devices with Threat Protection by NordVPN
