“Virtual currencies, perhaps most notably Bitcoin, have captured the imagination of some, struck fear among others and confused the heck out of the rest of us — including me.” – Senator Tom Carper, chair of the Senate Homeland Security and Governmental Affairs Committee, November 2013

Today is day 2 of our Fraud Awareness Week series, Fraud Stories and Lessons Learned, and we want to highlight the rapidly emerging problem of cryptocurrency fraud. Brad Moody, EVP of Operations for Lowers & Associates, points out the rapid increase in crypto-related fraud noting that in 2016 there were only 340 active fraud cases of such fraud and by 2020, there were more than 80,000 cases in the U.S. alone.

In this fraud story, Brad explains how current schemes to capture victim organizations’ cryptocurrency are amplifying the need for effective internal controls, anti-fraud training, and third-party penetration testing.

Listen to the story here:

Interestingly, one of the best ways organizations can protect themselves from cryptocurrency fraud is through the same tried and true practices used to prevent social engineering, phishing, and other related attacks. Employees are increasingly subject to scams through email and link-sharing, so it’s important to look at how to detect and block such activity but also to train employees on how to recognize and avoid becoming victims to such scams.

David Gardiner, Senior Vice President of Lowers Forensics International, offers further advice: “Crypto based currencies are now becoming a professionally acceptable form of tender. Now more than ever, corporations need to proactively mitigate their risk and exposure. This can be done through a myriad of operating procedures including the process of facilitating not only their outbound, but even incoming payments. Strict rules of engagement, much like the protocols already used in wire transfers (verbal confirmation, dual signature authentication, etc.) should be followed here as well.”

Stay tuned tomorrow for another fraud story from the front lines of Lowers & Associates.

According to the Association of Certified Fraud Examiners (ACFE), a single case of occupational fraud costs the victim organization an average of more than $1.5 million, and Certified Fraud Examiners (CFEs) estimate that organizations lose 5% of their revenues each year to fraud. In the ACFE’s 2020 Report to the Nations, a study of 2,504 cases of occupational fraud investigated by CFEs in 125 countries, the typical fraud lasted 14 months before it was detected and caused a median loss of $8,300 a month.

In an effort to educate organizations on the reality of fraud and to increase awareness of the controls that can help reduce fraud, each year the ACFE sponsors Fraud Awareness Week. Today marks day one of our Fraud Week series, Fraud Stories and Lessons Learned, and we are pleased to introduce Milton de Oca, Director of Operations for Lowers & Associates International. Prior to joining L&A, Milton served 32 years as a police officer with the Miami police department, a gangs sergeant, and finally, as the commander of the intelligence and terrorism unit.

Milton tells the story of an attempted fraud he and the L&A team helped to uncover and resolve in South America related to the procurement of ballistic vests that were to be used for dignitary protection.

Listen to the story here:

This interesting case demonstrates that fraud can come in many forms and at any level. Often it takes a considerable amount of investigation to uncover the fraud and while, in this case, we were able to exonerate the client of the loss, the ACFE reports that most organizations (54%) do not ever recover the losses they suffer at the hand of occupational fraud.

Milton advises all organizations to enlist the help of an independent outside source in cases like these in order to conduct an unbiased investigation.

Stay tuned tomorrow for another fraud story from the front lines of Lowers & Associates.

Where Are the Whistleblowers and Auditors?

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

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.

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:

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.”

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 article. 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.

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 learn about the critical role of whistleblowers and auditors in your fraud prevention program.

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).