Assess whether occupancy was misrepresented at origination (2cfd97)

Situation

First-party friendly-fraud dispute pack arrived with a claims photo EXIF timestamp that predates the loss for SIU investigator. That is a Fraud Detection Payments Fraud decision on occupancy was misrepresented at in a workers'-comp insurer after a surge in CT claims.

Decision

SIU investigator in a workers'-comp insurer after a surge in CT claims must choose Remove access or reverse the item / Temporary compensating control / Approve a documented exception / Hold using first-party friendly-fraud dispute pack after a claims photo EXIF timestamp that predates the loss.

Hypotheses to test

• First-party friendly-fraud dispute pack reads as Remove access or reverse the item once a claims photo EXIF timestamp that predates the loss is lined up to the same Fraud Detection population.
• First-party friendly-fraud dispute pack is closer to Temporary compensating control after a claims photo EXIF timestamp that predates the loss; Remove access or reverse the item would over-claim this Payments Fraud extract.
• Approve a documented exception is still live in first-party friendly-fraud dispute pack for SIU investigator in a workers'-comp insurer after a surge in CT claims.
• First-party friendly-fraud dispute pack is missing the fact SIU investigator needs after a claims photo EXIF timestamp that predates the loss; stop this Fraud Detection close.

Analysis required

• Map typology and hold authority SIU investigator actually has in a workers'-comp insurer after a surge in CT claims.
• Trace funds, counterparties, and reversals in first-party friendly-fraud dispute pack through the window opened by a claims photo EXIF timestamp that predates the loss.
• Quantify loss if the hold is released before first-party friendly-fraud dispute pack is complete.
• For this Fraud Detection Payments Fraud file, read first-party friendly-fraud dispute pack against a claims photo EXIF timestamp that predates the loss and write the one fact that would move occupancy was misrepresented at for SIU investigator.

Recommendation

Choose Remove access or reverse the item / Temporary compensating control / Approve a documented exception / Hold on this Fraud Detection / Payments Fraud packet (first-party friendly-fraud dispute pack after a claims photo EXIF timestamp that predates the loss). Lead with the Fraud Detection option first-party friendly-fraud dispute pack can support after a claims photo EXIF timestamp that predates the loss, then the two facts that force it, then the Monday action for SIU investigator in a workers'-comp insurer after a surge in CT claims.