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Indicators Of Fraudulent Foreign Health Insurance Claims: The Workbook for Insurers' Claims Examiners and SIU Investigators

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