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Baruch Antifraude & Segurança
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Fraud investigation for insurers

An inconsistency in a claim needs to be examined alongside its timeline, documents and participants. Baruch investigates events, service providers and payments to explain discrepancies, gather evidence and support case assessment, including tracing funds where there are indications that money has been diverted.

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PRACTICAL APPLICATIONS

From the situation to investigation deliverables.

See which facts need clarification, the relevant services and the deliverable associated with each one.

SITUATION 01

A claim with inconsistent information

The account of a claim differs from dates, photographs and available records. The estimate includes possibly pre-existing damage, and some participants recur in similar incidents. The insurer needs to reconstruct events and verify connections without treating an isolated discrepancy as proof of fraud.

Solutions that may help

Related deliverables

  • A timeline of the facts, documents, images and communications examined, including identified inconsistencies.

    Delivered throughFraud Investigations

  • A map of connections between participants, providers and beneficiaries, with verified information and open questions.

    Delivered throughThird Party Investigation
Decision supported

Decide which facts need further investigation before assessing possible measures.

SITUATION 02

A claim payment directed to an unrecognised recipient

Bank details for a claim payment change during processing, and the beneficiary reports that the money was not received. The insurer needs to verify authorisations, identify documented recipients and examine connections between accounts, intermediaries and providers to assess possible recovery measures.

Solutions that may help

Related deliverables

  • A map of documented transfers, amounts and identified destinations to support assessment of recovery measures.

    Delivered throughAsset Tracing and Recovery Support

  • A dossier on the recipients and intermediaries investigated, with connections and discrepancies against payment authorisations.

    Delivered throughThird Party Investigation
Decision supported

Guide further checks and assessment of measures by the appropriate teams.

Other signals worth investigating

  • Pre-existing damage presented as part of a new event or expenses inconsistent with the incident.
  • Reused documents, beneficiaries with undisclosed connections or changed bank details.

Illustrative situations, not client cases. Solutions and deliverables depend on the need, available information and agreed scope.

Describe the situation and the decision you need to make.

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REFERENCES

Sources to understand the risks.

Reference publications on the schemes and risks described in the examples.

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Baruch · Physical and cyber fraud

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