WORKBOOK
Indicators Of Fraudulent Foreign Health
Insurance Claims: The Workbook for insurers’
Claims Examiners and SIU Investigators
TABLE OF CONTENTS
Introduction ………………………………………………………………………………
I
Indicators of Fraudulent Foreign Health Insurance Claims …………………………
II
The 8-Point Step: 8 Steps to take in examining and reviewing health
Insurance and medical expenses claims worldwide …………………………………
III
Introduction to the Fraud Indicators Scale / Working Examples ………………
IV
The Fraud Indicators Scale (FIS) …………………………………………………
Working Examples
· Africa ………………………………………………………………………………
· Asia/Australasia ………………………………………………………………….
· South America/Central America/the Caribbean ……………………………..
· The Middle East ………………………………………………………………….
· United States/Canada/Europe …………………………………………………
V
Instructing the field Investigator /
Advising the fraudulent claimant about the investigative result ……………..
Appendix
200 countries and territories: The name and capital city,
official language(s), currency and code,
and the telephone code ……………………………………………………….
· Africa (55 countries and territories) …………………………………………
· Asia/Australasia (32 countries and territory) ……………………………….
· South America/Central America/the Caribbean
(48 countries and territories) ………………………………………………..
· The Middle East (12 countries) ……………………………………………..
· United States/Canada/Europe
(53 countries and territories) …………………………………………………
APPENDIX
200 countries and territories: The name and capital city, official language(s), currency and code, and the telephone code
ALPHABETICAL LIST OF COUNTRIES