Life

 - Questionable circumstances surrounding reported death; staged death/false identity.

 - Suspicious or questionable actions by applicant or policyholder (insured’s health misrepresented on application; suspicious timing of application in relation to insured’s death); potential for monetary gain from life insurance policy. Include suspicious claims involving murder for profit and claims pertaining to viatical settlements.

Workers' Compensation

 - Suspicious employee applicant claim.

Defrauding Employee - Employer committing illegal act against employee(s).

 - Legal provider inflates billing or materially misrepresents the facts.

 - Medical provider inflates billing, knowingly submits bills with improper medical codes and misrepresents facts.

 - Pharmacy inflates bills or falsifies codes.

 -Misclassifying the type of workers to obtain workers’ compensation coverage at a lower premium. (Example: classifying roofers as clerical, etc.)