Fraud Week 2020: Fraud Runs Amok

By Lowers & Associates,

Fraud Runs Amok: Where Are the Whistleblowers and Auditors Today? Sergio P. Negreira, CPA, CFF, JD EVP, Latin America & Global Forensics Services Lowers Forensics International

Where Are the Whistleblowers and Auditors?

Today, we continue our special 5-part Fraud Week Coffee Break Series where we invite you to spend 10 minutes each day learning about various aspects of fraud detection and prevention through the eyes of our Certified Fraud Examiners and other fraud experts.

For this episode, we interviewed Sergio Negreira, CPA, CFF, JD. Sergio is Executive Vice President, Latin America and Global Forensics Services for Lowers Forensics International. He specializes in forensic investigative services, FCPA and fraud risk assessments, corporate compliance, lost profit calculations, economic and market analysis, alternative dispute resolution in domestic and cross border disputes, and business interruption/fidelity insurance claims. Negreira has investigated fraud cases around the globe for the past 27 years.

Fraud Week is an annual movement, organized by the Association for Certified Fraud Examiners (ACFE), to champion the need to proactively fight fraud and help safeguard businesses and investments from the growing fraud problem.

In its 2020 Report to the Nations on Occupational Fraud, the ACFE looked at how fraud is detected. As it turns out, 43% of occupational fraud is detected by tips. The next most common way is 15% by internal audit. These statistics underscore the vital role of whistleblowers and the need for organizations to provide programs that enable employees and others to be able to safely report suspicious activity.

Grab a cup of coffee and spend 8 minutes listening to Negreira’s view on the critical role of whistleblower programs in fraud detection.

Fraud Detection

Whether by whistleblowers or other methods, fraud detection is a concept organizations need to understand in order to limit the losses they suffer at the hands of fraud. The faster organizations can detect fraud, the smaller the size of the loss. According to the ACFE, “It is also key to fraud prevention because organizations can take steps to improve how they detect fraud, which in turn increases the staff’s perception that fraud will be detected and might help deter future misconduct.”

As mentioned, by a large margin, tips from whistleblowers are the most common way occupational frauds are uncovered. This fact underscores the importance of cultivating and thoroughly evaluating tips that come in through your whistleblower program.

Here’s what the data reveals about fraud detection methods:

How is occupational fraud initially detected?
Source: ACFE 2020 Report to the Nations

 

How COVID-19 is Impacting Whistleblowers and Auditors

Preventing, detecting, and investigating fraud is more difficult during the COVID-19 pandemic. In fact, according to the ACFE’s COVID-19 Benchmarking Report, “An inability to travel is still the most significant challenge in combating fraud right now, but more people are citing conducting remote interviews as a current top challenge.”

Negreria adds, “In COVID, since a lot of people are still working remotely, a lot of employees can’t observe other employees’ habits and what they’re doing. And in general, investigating during COVID is very difficult because companies aren’t open and travel is more difficult.”

Despite the challenges, organizations are wise to continue to support whistleblower programs and maintain their focus on fraud detection and investigations during the pandemic where the pressure, opportunity, and incentive for fraud is very high.

We hope you enjoyed this Coffee Break episode. Come back tomorrow to hear from Carlos Rivera, CFE, MAFF, Senior Vice President – Caribbean & Latin America of Lowers Forensics International and Grant Mizel, Financial Analyst, Emerging Markets of Lowers Risk Group. Rivera and Mizel will speak about situational awareness and the Fraud Triangle during COVID-19.

Fraud Week 2020: Fraud in the Time of COVID-19

By Lowers & Associates,

Is the Pandemic Helping to Mask Fraud?

Fraud Week is an initiative of the Association of Certified Fraud Examiners (ACFE) to promote anti-fraud awareness and education. Today, we begin a special 5-part Fraud Week Coffee Break Series where we invite you to spend 10 minutes each day learning about various aspects of fraud detection and prevention through the eyes of our Certified Fraud Examiners and other fraud experts.

For this episode, we interviewed Mark Lowers, CFE, Founder and CEO of Lowers Risk Group, and Brad Moody, CFE, CFI, EVP of Operations for Lowers & Associates.

In its 2020 Report to the Nations on Occupational Fraud, the ACFE looked at common types of fraud and popular ways perpetrators conceal their activities. A related study from the ACFE explored the reported increase in fraud during the COVID-19 pandemic. What’s behind the increase? And how can organizations better protect themselves from becoming victims? We begin here.

Grab a cup of coffee and spend 8 minutes listening to the experienced voices of Mark Lowers and Brad Moody:

According to the ACFE, there are three primary categories of fraud: Asset misappropriation (seen in 86% of reported cases), corruption (43% of cases), and financial statement fraud (10% of cases). Within those broad categories are a number of fraud types:

The Fraud Tree:


Source: ACFE Report to the Nations

Considering that organizations lose 5% of their revenues to fraud each year, it’s helpful to understand how fraudsters are able to conceal their activities. Here’s what the ACFE report found:


Source: ACFE Report to the Nations

“(Bad actors,) especially in the IT world, one thing that they’re very good at is they’re very patient so a lot of the systems that have been impacted have been inside the corporate networks for a long time in order to gather information in order to perpetrate the crime,” explains Brad Moody.

Adding in the COVID Layer

We also have to look at how the COVID-19 pandemic crisis has impacted fraud. The ACFE is reporting increases across the board in nearly every type of fraud during COVID and expects these impacts to continue to have an impact for some time to come.

Mark Lowers explains it this way: “It’s really not that surprising (to see an increase in fraud right now) on the basis you have a tremendous remote workforce today. And those that are in designated work environments, you’re working with reduced staff because not everybody is considered essential. So, the layers of controls and the layers of operational controls that have historically been in place, in some cases people are doing workarounds to get work done. Anytime you do those workarounds, you have an opportunity for fraud to occur.”


Source: ACFE, Fraud in the Wake of COVID-19: Benchmarking Report

As the ACFE explains, “Travel bans, employees working remotely, and an increased reliance on technology and economic uncertainty have become the reality for many organizations around the world. And while these and other hurdles present numerous logistical and operational challenges, they also open the door to the increased pressure, opportunity, and rationalization that can lead to fraud.”

In fact, the ACFE report found increases in cyber fraud (social engineering, phishing, ransomware schemes), financial statement fraud, payment fraud, and employee embezzlement. Just about every category of fraud has been on the rise during the pandemic.

Lessons Learned from the Financial Services Industry

Cash is the culprit in many asset misappropriation schemes (theft of cash on hand, theft of cash receipts, fraudulent disbursements) and these cash-related fraud schemes can last a median duration of 14 months or more. The longer a fraud remains undetected, the greater the financial loss.

Here at Lowers Risk Group, we work extensively with the financial services industry and specifically with the cash servicing industry. As Mark Lowers and Brad Moody explained, while the industry, on the whole, is doing a great job during these extremely tough circumstances to protect their people and assets, the industry also provides a perfect backdrop for organizations of all types looking for ways to shore up their own internal controls.

We hope you enjoyed this first Coffee Break. Come back tomorrow to hear from Sergio Negreira, CPA, CFF, JD about the critical role of whistleblowers and auditors in your fraud prevention program.

 

Emotional Intelligence & The Allure of Insurance Fraud

By Lowers & Associates,

Emotional Intelligence and the Allure of Insurance Fraud

By Neil Watson and Keith Gray

Insurance loss happens for many reasons.  For a business, common causes include armed robbery, theft, customer injury, floods, fires, and storm damage; but any natural disaster, large-scale event, or man-made act can bring about a claim.  When an event involves the loss of physical stock or damage to property, the loss is immediate, and it creates an urgent need for the business owner to settle the claim so that the business can resume operations and avoid further lost revenue.

This desire to quickly return to business as usual is a natural one, but in the wake of an event, it’s not uncommon for the resolution process to test the business owners’ resolve.  And while most claims post-incident are legitimate, from time-to-time, human emotions will complicate the process and create an environment that enables fraudulent activity, sometimes in unexpected ways.

Why Does Insurance Fraud Happen?

The Fraud Triangle provides all the insight required to answer this question.  Our team has written extensively on this, but Donald Cressey’s hypothesis in his book “Other People’s Money” says it all: Trusted persons become trust violators when they conceive of themselves as having a financial problem which is non-shareable, are aware this problem can be secretly resolved by violation of the position of financial trust, and are able to apply to their own conduct in that situation.”

It’s true that some fraudulent claims start out as legitimate but become ‘exaggerated’ during the claims process due to perceived opportunity.  In other cases, if the business is not doing well and is losing money, desperation can create enough pressure to commit fraud.  In rare cases, the fraud may involve large organized criminal gangs; these are often well-planned and involve multiple parties where the sole intent of the activity is a rational attempt to defraud an insurance provider.

It’s for these reasons that impartial guidance through the claims process is crucial.  As an insured, it is important to work closely with your insurance broker and the loss adjuster in preparing your claim and validating your losses.  Without this professional assistance and oversight, fraud can easily find its way into the conversation.

How Does Insurance Fraud Happen?

Below are a few examples of insurance fraud we’ve seen over the years at Lowers & Associates:

  • ‘Padding’ legitimate claims to increase the claim amount
  • Including losses from previous shortages or events within a big ‘single event’ claim
  • Manipulating inventory, possibly running two sets of books, to allow for the tracking of actual inventory versus the falsely reported inventory
  • Exaggerating the damage suffered as a result of a natural disaster (storm), or even causing some additional damage not caused by the original disaster
  • Committing arson
  • Staging accidents or thefts

The current COVID-19 situation globally, coupled with other localized events (recent looting losses in the U.S. or the extreme poverty facing certain areas in Brazil), is resulting in retail sales for certain sectors falling by over 50% and as much as 100%, which is clearly not sustainable.

In such unprecedented times as these, the possibility of a spike in fraudulent claims is a real concern. There is an increase in both the pressure and opportunity factors, resulting in an increased likelihood that potential perpetrators may rationalize their fraudulent thoughts and act on them as a result. For business owners, it can be hard to find consistency and understand what their default problem-solving steps should be.  When the Lowers & Associates team is presented with uncertainty, we often lean on process and procedure to identify a way forward in our work together with clients.  This path can always be informed by intuition, experience, and empathy, but for a business, without process and procedure to provide impartiality, the risk of insurance fraud increases significantly.

What Can You Do About It?

Ideally insurers would commission a pre-risk survey to establish security protections, stock levels, and standard operating procedures to satisfy themselves that the risk meets their requirements.  While this is recommended, it is not always feasible due to time or cost restraints.

Post-event, once a claim has been filed, relying on the findings of a law enforcement investigation may not be feasible due to timing or any related circumstances related to the event (especially if it’s large-scale or a natural disaster).  And even if law enforcement is doing an investigation on an event, it may not be a priority, creating an extended period of uncertainty.  Lastly, law enforcement may also be very hesitant to provide any info that they do have knowledge of, especially when it is an active investigation.

To manage this process, business owners and insurers need independent third parties that are flexible, have experience across multiple industries and can dedicate the appropriate time required to work through a claim (i.e. gathering facts, evidence and necessary documents) to support the basis of the claim.  For truly complex fraud matters, business owners and insurers should expect the third party to have a Special Investigations Unit (SIU) with extensive experience in technical surveillance countermeasures (TSCM) and counterintelligence that regularly work on international assignments.

With enterprise risk mitigation and insurance solutions that include UAV/UAS, special investigations, forensic accounting, loss adjusting and more, Lowers Risk Group stands ready to support our clients through the claims process with the speed, accuracy and dedication you’ve come to expect from over 30 years in the business.  To learn more, contact us.

About the Authors

Neil Watson brings nearly 30 years of insurance industry experience to Lowers & Associates, where he currently serves as Global Operations Director.  With key insurance industry relationships in both the London and International insurance markets, Neil’s primary responsibility is to grow all verticals and assist in building out L&A’s claims adjusting capabilities.

Keith Gray has been with Lowers & Associates for over 15 years and currently serves as the VP of Client Relations.  In his current role, Keith provides oversight with respect to program coordination, management of a nationwide team of industry professionals, investigation, and client communication.  Keith possesses a degree in Accounting and is certified as both a Certified Fraud Examiner (CFE) and Certified Anti-Money Laundering Specialist (CAMS).

  Category: Occupational Fraud
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Due Diligence: Your Lucky Day?

By Tom Dolan,

Due Diligence: Your Lucky Day?

Imagine your business is being asked to partner with the trendiest new luxury goods distributor. They have a strong presence throughout Europe, are establishing a growing network of suppliers, and come backed by some significant capital. Wow! It MUST be your lucky day!

Or is it?  A quick look into the distributor’s leadership reveals that the principal supplying that capital is best known for stepping down as the founder and CEO of his previous business after multiple Lacey Act violations, including unethical sourcing and the sale of dangerous, toxic products. These violations cost his previous company millions in criminal penalties.

Not to ruin the fantasy here, but this is the real world (and a true story).  Proper due diligence saved the business from this bad partnership before it could happen.  It truly was their lucky day.

This positive outcome is less common than you might think. Fraud is everywhere, but just a small amount of basic due diligence can help a business avoid it or other unnecessary risks. From a small-town pawnbroker that lost his business after hiring a friend whose felonious past was only revealed after a six-figure theft, to a multinational corporation that lost millions in fraudulent payments to a duplicitous supply contractor living well beyond his means, there are countless stories demonstrating the steep price paid by companies that trusted before verifying.

What is due diligence?

Due diligence is a specific but flexible process performed by qualified experts to identify and obtain disparate information to form a complete picture.  In the above example, the research would have included the history and business filings of the company (as well as those of the principles, owners or key management) and any actual or perceived affiliations, to name a few.

Why do businesses need it?

New personnel or new partners can shape the future of your business.  Whether it’s a college coach, a board member or a supplier, the whole story matters and should include:

  • Investigation of Character
  • Investments
  • Acquisitions
  • Mergers
  • Assets identification (for debt enforcement and recovery)
  • Location

What else should I know about due diligence?

It’s always important to understand who you’re working with to eliminate the potential for fraud. When doing your due diligence, here are some best practices to consider:

  • Access to public records. A subject’s criminal record (or lack thereof) is of prime importance, but equally significant may be history of litigation or bankruptcy. Even seemingly minor issues like traffic infractions may be indicative, especially when a subject has tallied dozens.
  • Complete and comprehensive history. The most thorough background investigations can reveal the truth of what’s been put forward in a resume or MOU and what may have been deliberately omitted.  Ask the questions that illuminate the answer.
  • Asset verification. Before entering into any formal arrangement, understand and confirm a potential partner’s claimed resources and reveal when things don’t add up.  Don’t underestimate the power of pressure in the Fraud Triangle.
  • Social media review. Despite its prevalence, not everyone uses it wisely. A review of both personal and corporate profiles can identify some of the most egregious red flags.  Consider recurring sweeps to mitigate or uncover your exposure.

BONUS: Red Flags

Incompetence is often much more apparent than criminal activity.  When evaluating a person or vendor, does your due diligence evaluation include the following?

  • History of mismanagement
  • Jumping from job to job
  • Living beyond perceived means
  • Having a history of “start-ups” or serial entrepreneurial ventures
  • Relocation, either town to town, or state to state
  • Longer and undefined timeframes with no employment

If your business is struggling with due diligence or would like to set up a consultation in-person or remotely, please reach out to us.

  Category: Due Diligence
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COVID-19 and the Fraud Triangle

By Lowers & Associates,

COVID-19 and the Fraud Triangle

In our work in high risk industries, we routinely uncover fraud and asset misappropriations. While it may seem counterintuitive, with the US and global economy currently at a standstill due to COVID-19 shelter at home directives, organizations should be on high alert for occupational fraud during this time. The Fraud Triangle provides a framework for explaining why this is.

Formulated in 1953 by criminologist Donald Cressey, the Fraud Triangle theorizes that fraud occurs when the fraudster feels financial pressure, they are presented an opportunity, and/or the person can rationalize the theft.

With record numbers of Americans filing for unemployment and organizations operating with skeleton crews, the circumstances are ripe for fraud to take place.

A “Perfect Storm” of Conditions

Today, with organizations shut down to outside visitors (including, in some cases, outside auditors) as well as many employees, we are seeing a virtual petri dish for fraud. Two corners of the Fraud Triangle – opportunity and rationalization – are getting bent pretty hard. The third corner, incentive, in the form of extreme pressure, is bent even further. People have less supervision, more opportunity, and way more financial pressure.

So while you’re dealing with this pandemic and the resulting disruption, now more than ever is the time to be vigilant.

Opportunity

The coronavirus pandemic has driven unprecedented change in the workplace. Many employees are either laid off, have taken a pay cut, and/or are working remotely. Those who remain, whether at the workplace or from home, may be working with less supervision than before. In fact, we are seeing many instances where key risk management procedures like dual controls have been weakened or suspended entirely. For example, instead of having two or more employees independently evaluate and compare financial records, now only one employee may be responsible. Or, that supervisory signature normally required on certain transactions? It’s no longer practical given our remote locations, so we’ll just “do it this way” in the interim.

Sound familiar? The problem in these scenarios is that one small transgression that goes unnoticed has a way of snowballing into full-blown fraud.

Rationalization

When opportunity and incentive exist, people are better able to rationalize their fraudulent behavior. That couldn’t be more true than during this pandemic.  “I have to do this to provide for my family. I’ll pay it back later. My employer deserves it for laying me off.” These are some of the underlying rationalizations that turn a fraudster’s underlying thoughts into an actionable theft.

Incentive/Pressure

Financial difficulties are at the top of the list in terms of the pressures that can motivate people to commit acts of fraud. At no other time in modern history have so many people been under such financial strain as they are today.

At the highest of levels of unemployment following the 2008 financial crisis, there were 15.3 million jobless Americans. By the third week of April 2020, 26.5 million workers had filed jobless claims as a result of the coronavirus. An estimated 33 million people are currently unemployed, representing nearly 21 percent of the workforce and the highest unemployment level since 1934. Many who remain employed have agreed to accept pay cuts, work reduced hours, or take unpaid furloughs.

While the $2 trillion stimulus bill, Coronavirus Aid, Relief, and Economic Security Act (CARES), provided some short-term relief, it is likely not enough to stem the extreme financial worry being felt by many who don’t know how they’ll pay next month’s mortgage or cover their car insurance premium.

The pressure is extreme.

The Takeaway? Stay Vigilant

It may be tempting for organizations to be complacent when the world seems at a standstill, but the time to be diligent is now. Businesses should be on “high alert” and taking measures to ensure they’re keeping their operations secure. That includes double checking that access to IT systems and software has been blocked for furloughed employees or that virtual private networks (VPNs) have been created for remote workers. Internal controls should also remain in place, even if they have to be modified temporarily. For example, regularly scheduled phone calls or video conferences send the message that you’re still monitoring employees’ activities. Finally, if you haven’t already done so, it’s a good time to do an updated risk assessment for the entire organization. Asking your team where new vulnerabilities might exist, whether internal controls are still functioning as intended, and what gaps have been created are all part of mitigating the risk potential associated with the Fraud Triangle.

If you’d like help conducting any of these assessments, please reach out to us.