The Financial Crimes Enforcement Network (FinCEN), a bureau of the United States Department of the Treasury that collects and analyses information about financial transactions in order to combat domestic and international money laundering, terrorist financing, and other financial crimes launched an Advisory on Unemployment Insurance Fraud During the Coronavirus Disease 2019 (COVID-19) Pandemic.
This advisory is aimed “to alert financial institutions to unemployment insurance (UI) fraud observed during the COVID-19 pandemic. Many illicit actors are engaged in fraudulent schemes that exploit vulnerabilities created by the pandemic. This advisory contains descriptions of COVID19-related UI fraud, associated financial red flag indicators, and information on reporting suspicious activity”.
We published recently that COVID-19 continues to affect businesses in a myriad of ways. Organisations are having to adapt quickly to the fast-changing climate of the pandemic, and unfortunately, we’ve recently noticed some business practices of cutting steps in a few internal processes, such as hiring, or lack of risk management controls. It’s a vulnerable time for organisations – earlier we wrote that a crisis can bring out the worst in some people. Fraudsters who prey on people’s fear and confusion tend to waste no time when a global pandemic strikes. COVID-19 is relatively new, yet fraud schemes are multiplied much like the virus itself as criminals look for vulnerabilities among a fearful population. This pandemic also creates risks for employee fraud – CRI Group’s survey revealed that nearly 77 percent of HR professionals accept that there is a risk that employees can initiate fraudulent activity because of the work-from-home arrangement.
But employee fraud might not be the only risk the organisations face today. Earlier this year, we published that some organisations commit fraud themselves and abuse the Coronavirus Job Retention Scheme by engaging in furlough fraud. They do this by accepting taxpayer money designed to help them pay salaries for furloughed workers, who are essentially “deactivated” due to loss of business and quarantine – yet they pressure them to work (or they accept furlough benefits without the employees’ knowledge).
As we can see, a fraudulent activity might happen in a myriad of ways. Let’s dive in what are the red flag indicators of unemployment insurance (UI) fraud as unemployment claims across the globe have surged due to the COVID-19 pandemic.[/vc_column_text]
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What are the red flags of unemployment insurance fraud?
In the advisory, FinCEN lists the financial red flag indicators to alert financial institutions to fraud schemes targeting UI programs, and to assist them in detecting, preventing, and reporting suspicious transactions related to such fraud. The illicit activity might include employer-employee fraud-related activities, such as creating a fake company with fictitious employees and providing fabricated details such as wages, or conspiracy between the two parties when an employee receives UI payments while the employer continues to pay reduced and/or officially undisclosed salaries. The fraud scheme might also be happening under the ‘misrepresentation of income fraud’ when the applicant fails to provide the correct income/wage details, or even submits an application with stolen or fake identity information.
A similar case happened when the COVID-19 was in a full swing last year: one for-sale ad was published in the black-market specialising in selling stolen accounts and data – it was for access of the stolen UI claim in California that had been approved and offered benefits worth $17,550. This is just one example of the fraudulent activities – “in California, fraud was so pervasive that officials have suspended processing jobless claims for two weeks to put new controls in place and reduce a bulging backlog”. It also resulted in The U.S. Labor Department making fraud detection a priority and allocating $100 million to combat the issue. To support this fight against illicit activities, FinCEN identifies the following red-flag indicators:
- Account(s) held at the financial institution receive(s):
- UI payments from a state other than the state in which the customer reportedly resides or has previously worked;
- Multiple state UI payments within the same disbursement timeframe;
- UI payments in the name of a person other than the accountholder, or in the names of multiple unemployment payments recipients;
- UI payments and regular work-related earnings, via direct deposit or paper checks;
- Numerous deposits or electronic funds transfers (EFTs) that indicate they are UI payments from one or more states to persons other than the accountholder(s);
- A higher amount of UI payments in the same timeframe than similarly situated customers received.
- The customer withdraws the disbursed UI funds in a lump sum by cashier’s checks, by purchasing a prepaid debit card, or by transferring the funds to out-of-state accounts.
- The customer’s UI payments are quickly diverted via wire transfer to foreign accounts, particularly to accounts in countries with weak anti-money laundering controls.
- The customer receives or sends UI payments to a peer-to-peer (P2P) application or app. The funds are then wired to an overseas account, or withdrawn using a debit card, in a manner that is inconsistent with the spending patterns of similarly situated customers.
- Individuals quickly withdraw disbursed UI funds via online bill payments addressed to an individual(s), as opposed to businesses, as payee(s), with some individual payees receiving multiple online bill paychecks over a short time period.
- The IP address associated with logins for an account conducting suspected UI-fraud activities does not map to the general location of stated address in identity documentation for the customer or where the UI payment originated.
- Individuals direct UI-related EFTs, or deposit UI checks into suspected shell/front company accounts, which may be indicative of money mules transferring these funds in and out of the accounts.
- Multiple accounts receiving UI payments at one or more financial institutions are associated with the same free, web-based email account that may appear in more than one UI application.
- A newly opened account, or an account that has been inactive for more than thirty days, starts to receive numerous UI deposits.
- After a financial institution suspects UI fraud and requests additional identification documentation to verify the identity(ies) of the customer(s), queried individuals provide documents that are incorrect or forged, which may be an indicator of an account takeover or identity theft. After a financial institution suspects UI fraud and conducts due diligence, it determines that the customer does not have a history of living at, or being associated with, the address to which the UI check or UI debit card is sent, or within the geographical area in which the registered debit card is being used.
Insurance fraud is something that no company can afford. It is a serious crime that can result in serious consequences for fraudsters who may find their future job prospects impacted, find it harder to obtain insurance and other vital financial services, obtain a criminal conviction and even face the prospect of imprisonment. CRI Group’s insurance fraud investigations cover the full range of insurance fraud cases, from healthcare fraud to disability and even fake death claims. Our experts are trained to look for the tell-tale signs of fraud: they can view claims, medical and hospital records, conduct interviews, examine statements and documents, as well as perform on-site inspections.
Enhanced risk management
At CRI Group, we suggest you consider looking at your overall risk management process, involving not only potential insurance fraud risks during the COVID-19 pandemic, but a broader range of employee, bribery and corruption, compliance risks your organisation might face.
The “Risk Management & ABMS Playbook” provides tools, checklists, case studies, FAQs and other resources to help you lead your organisation into better preparedness and compliance. Our experts share their own plays to help you reduce risk, thereby preventing and detecting more fraud. The first section addresses risk management directly: proper third-party due diligence and critical background screening take centre stage for this game plan. Section two tackles bribery and corruption, with tried-and-true measures you can implement to stay better protected and in compliance with strict laws and regulations.
Speak up – report illegal and unethical behaviour
If you find yourself in an ethical dilemma or suspect inappropriate or illegal conduct, and you feel uncomfortable reporting through normal channels of communication, or wish to raise the issue anonymously, use our Compliance Hotline. This hotline is available to all everyone in a business relationship with CRI Group and ABAC Group. It is an anonymous reporting mechanism that facilitates reporting of possible illegal, unethical, or improper conduct when the normal channels of communication have proven ineffective, or are impractical under the circumstances.