Fraud investigation - Study guides, Class notes & Summaries

In New Jersey, and insurer must provide at least______ advance notice for cancellation of property coverages for nonpayment of premium - Answer- 10 days The employment of another producer by a producer is subject to all of the following requirements, except a. the employer shall examine the credentials of the kinds of business described in the contract. b. the employer shall be responsible for the insurance related conduct of the employee c. the employee producer will conduct business und...

Texas All Lines Adjuster Laws & Regulation exam 2023. 1. All of the following are exempted from the requirement of an adjuster's license examination except: A. Those persons holding CPCU designation; B. those persons adjusting workers compensation claims; C. Those persons who have received the Associate in Claims (AIC) designation; D. Those persons who have a certificate of completion showing that within the past 12 months the applicant has completed a certified adjuster prelicensing ...

A forensic investigator is called to the stand as a technical witness in an internet payment fraud case. Which behavior is considered ethical by this investigator while testifying? Providing and explaining facts found during the investigation Interpreting the findings and offering a clear opinion to the jury Helping the jury arrive at a conclusion based on the facts Assisting the attorney in compiling a list of essential questions: Providing and explaining facts found during the investiga...

AHFI Examination Prep Course with Certified Solutions HCF Investigator Assumptions *General knowledge of the Health care Delivery System *Health plan policy and procedures relative to the delivery of services *Able to identify Red Flags, behaviors & indicators of health care fraud schemes Know applicable federal & state laws related to health care fraud *Law enforcement & regulatory agencies that have oversight responsibilities for HCF *Local & regional investigative groups ...

LML4806 PORTFOLIO MEMO - MAY/JUNE 2023 - SEMESTER 1 - UNISA (DETAILED MEMO - DISTINCTION GUARANTEED!) QUESTION 1 1.1 The Memorandum of Incorporation of Generators Unlimited (Pty) Ltd provides that only the board of directors, or any director authorised by the board, has the power to conclude contracts on behalf of the company. It also states that any transaction that exceeds R10 million must first be authorised by the company’s shareholders at a general meeting by way of an ordinary reso...

An operating style that shows excessive risk-taking to strengthen the balance sheet, for example, is generally a red flag for fraud. T/F CORRECT ANSWER T The Institute for Fraud Prevention (IFP) fulfills the first of its two missions with member organizations supported research by selecting projects and providing funding, guidance, and data that will help us better understand fraud with a long-term goal of reducing its incidence and effects. T/F CORRECT ANSWER T Laws such as the RICO...

AHIP fraud waste & abuse questions and answers already passed Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? Fraud Which of the following is not potentially a penalty for violation of the law or regulation prohibiting fraud, waste and abuse (fwa)? Deportation A person comes into your pharmacy to drop off a prescription for a beneficiary who is a regular customer. The prescription is for a controlled substance with a quantity of 160. This...

FOR2601 Assignment 1 (DETAILED ANSWERS) Semester 2 2024 - DISTINCTION GUARANTEED - DISTINCTION GUARANTEED - DISTINCTION GUARANTEED Answers, guidelines, workings and references ... QUESTION 1 1.1 Discuss in your own words the detection techniques that can be used by auditors to detect fraud in an organisation. (10) 1.2 Discuss the basic considerations or tactical steps you have to consider when starting a new investigation. (10) [20] QUESTION 2 2.1 Describe in your own words the “dangers...

CAS1501 Assignment 4 (ANSWERS) Semester 2 2023 - DISTINCTION GUARANTEED Answers, guidelines, workings and references ......................Study the following video transcription; -rolling right it's enough -grand corruption at the highest level for the longest time and sadly the consequences of the staff will still be felt for many years to come -let me refresh your memories -state capture is much more than just corruption it sets out to repurchase key constitutional functions in o...

As methods of communication evolve, it's important for claims professionals to remember that any written claims communication may be a. Replaced with verbal communication b. Misinterpreted c. Edited later d. Subpoenaed - d. Subpoenaed Soft fraud occurs when a claim is exaggerated and is also referred to as a. Opportunity fraud b. Financial fraud c. Reimbursement fraud d. Victimless fraud - a. Opportunity fraud In which one of the following scenarios is the right of subrogation most l...