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Fraud Unit Case Investigation Process

Each case received by the Fraud Unit is unique. While there may be a number of definable types of insurance fraud committed, such as staged burglaries, agent theft of premiums, inflated provider billings or unauthorized sale of insurance, the people, places, methods and motivations can vary greatly from case to case. Therefore, an investigator may use some or all of the investigative techniques available.

Below is a general outline of the case investigation process. This outline is intended to provide information regarding the range of activities that can occur. All activities listed may, or may not be undertaken for a specific case and may, or may not be conducted in the order shown:

  • Investigation Plan Developed
  • Coordinate Joint Investigation with other Agencies
  • Conduct Database Searches on Subjects
  • Letters and Inquiries Sent as Appropriate
  • Witnesses and Subjects Interviewed as Appropriate
  • Subpoenas Issued for Critical Documents
  • Documents and Data Collected and Analyzed
  • Conduct Surveillance as Needed
  • Coordination with Attorneys and DA
  • File Interim Reports as Needed
  • Execute Search Warrants as Needed
  • Present Case to the Grand Jury
  • Execute Arrest Warrants
  • Coordination with Attorneys and District or United States Attorney
  • Testify at hearings or trials

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Last updated: 10/08/2015

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