Assess whether a SAR narrative is supportable today after a claims photo EXIF

Situation

SIU investigator in a workers'-comp insurer after a surge in CT claims has one working extract — straw-buyer occupancy file — after a claims photo EXIF timestamp that predates the loss. If straw-buyer occupancy file cannot support a SAR narrative is, the honest Fraud Detection output is hold.

Decision

SIU investigator in a workers'-comp insurer after a surge in CT claims must choose Remove access or reverse the item / Temporary compensating control / Approve a documented exception / Hold using straw-buyer occupancy file after a claims photo EXIF timestamp that predates the loss.

Hypotheses to test

• SIU investigator can defend Remove access or reverse the item from straw-buyer occupancy file after a claims photo EXIF timestamp that predates the loss in a Fraud Detection challenge.
• SIU investigator cannot defend Remove access or reverse the item from straw-buyer occupancy file; Temporary compensating control is what the extract actually supports after a claims photo EXIF timestamp that predates the loss.
• A claims photo EXIF timestamp that predates the loss never reached the population in straw-buyer occupancy file — reopen intake, do not close a SAR narrative is.
• Two facts in straw-buyer occupancy file after a claims photo EXIF timestamp that predates the loss conflict for SIU investigator; hold this Payments Fraud file.

Analysis required

• Quantify loss if the hold is released before straw-buyer occupancy file is complete.
• Test a one-off dispute against the first edge of a scheme around a SAR narrative is.
• Check mule or round-trip markers in straw-buyer occupancy file.
• For this Fraud Detection Payments Fraud file, read straw-buyer occupancy file against a claims photo EXIF timestamp that predates the loss and write the one fact that would move a SAR narrative is for SIU investigator.

Recommendation

Choose Remove access or reverse the item / Temporary compensating control / Approve a documented exception / Hold on this Fraud Detection / Payments Fraud packet (straw-buyer occupancy file after a claims photo EXIF timestamp that predates the loss). If straw-buyer occupancy file cannot force a Fraud Detection label under Payments Fraud, stop. If straw-buyer occupancy file after a claims photo EXIF timestamp that predates the loss cannot support Remove access or reverse the item versus Temporary compensating control on this Fraud Detection Payments Fraud close, SIU investigator must do not infer a control or scheme beyond the transaction and entitlement evidence.