Assess whether linked accounts should be treated as one case (a30f97)

Situation

A P&C carrier's auto-body network cannot treat a mule account receiving 14 unrelated payrolls in a week as color commentary on ACH return-reason code R10 spike. Claims special-investigation lead must close linked accounts should be from that extract under Fraud Detection / Payments Fraud.

Decision

Claims special-investigation lead in a P&C carrier's auto-body network must choose Remove access or reverse the item / Temporary compensating control / Approve a documented exception / Hold using ACH return-reason code R10 spike after a mule account receiving 14 unrelated payrolls in a week.

Hypotheses to test

• ACH return-reason code R10 spike reads as Remove access or reverse the item once a mule account receiving 14 unrelated payrolls in a week is lined up to the same Fraud Detection population.
• ACH return-reason code R10 spike is closer to Temporary compensating control after a mule account receiving 14 unrelated payrolls in a week; Remove access or reverse the item would over-claim this Payments Fraud extract.
• Approve a documented exception is still live in ACH return-reason code R10 spike for claims special-investigation lead in a P&C carrier's auto-body network.
• ACH return-reason code R10 spike is missing the fact claims special-investigation lead needs after a mule account receiving 14 unrelated payrolls in a week; stop this Fraud Detection close.

Analysis required

• Map typology and hold authority claims special-investigation lead actually has in a P&C carrier's auto-body network.
• Trace funds, counterparties, and reversals in ACH return-reason code R10 spike through the window opened by a mule account receiving 14 unrelated payrolls in a week.
• Quantify loss if the hold is released before ACH return-reason code R10 spike is complete.
• For this Fraud Detection Payments Fraud file, read ACH return-reason code R10 spike against a mule account receiving 14 unrelated payrolls in a week and write the one fact that would move linked accounts should be for claims special-investigation lead.

Recommendation

Choose Remove access or reverse the item / Temporary compensating control / Approve a documented exception / Hold on this Fraud Detection / Payments Fraud packet (ACH return-reason code R10 spike after a mule account receiving 14 unrelated payrolls in a week). If ACH return-reason code R10 spike cannot force a Fraud Detection label under Payments Fraud, stop. If ACH return-reason code R10 spike after a mule account receiving 14 unrelated payrolls in a week cannot support Remove access or reverse the item versus Temporary compensating control on this Fraud Detection Payments Fraud close, claims special-investigation lead must do not infer a control or scheme beyond the transaction and entitlement evidence.