Fraud Cases Research Articles

Fraud, Access, and the Future of Telemedicine.

On July 20, 2022, the Department of Health and Human Services, Office of Inspector General (HHS-OIG), issued a Special Fraud Alert warning healthcare providers of increased fraudulent activity surrounding telemedicine companies. The Alert marks a further escalation of a multi-year effort by the Department of Justice (DOJ) and the HHS-OIG to crack down on multi-billion dollar fraud cases involving telehealth companies. It is the objective of this Commentary to place the HHS-OIG Special Fraud Alert in the context of enforcement efforts by the DOJ and HHS to stem the recent growth in telehealth fraud resulting from the COVID-19 pandemic. Taken together, it is apparent this is a critical moment in the evolution of telehealth and it is crucial to strike a proper balance between effective regulation and enforcement on the one hand, and access to care on the other.

Incidents and Potential Adverse Health Effects of Serious Food Fraud Cases Originated in Asia.

Food fraud has long been regarded as a major issue within the food industry and is associated with serious economic and public health concerns. Economically motivated adulteration, the most common form of food fraud, has consequences for human health, ranging from mild to life-threatening conditions. Despite the potential harm and public health threats posed by food fraud, limited information on incidents causing illness has been reported. Enhancing the food control system on the Asian continent has become crucial for global health and trade considerations. Food fraud databases serve as valuable tools, assisting both the food industry and regulatory bodies in mitigating the vulnerabilities associated with fraudulent practices. However, the availability of accessible food fraud databases for Asian countries has been restricted. This review highlights detrimental food fraud cases originating in Asian countries, including sibutramine in dietary supplements, plasticizer contamination, gutter oil, and the adulteration of milk. This comprehensive analysis encompasses various facets, such as incident occurrences, adverse health effects, regulatory frameworks, and mitigation strategies.

Fraud Detection and Analysis for Insurance Claim using Machine Learning

Insurance Company working as commercial enterprise from last few years have been experiencing fraud cases for all type of claims. Amount claimed by fraudulent is significantly huge that may causes serious problems, hence along with government, different organization also working to detect and reduce such activities. Such frauds occurred in all areas of insurance claim with high severity such as insurance claimed towards auto sector is fraud that widely claimed and prominent type, which can be done by fake accident claim. So, we aim to develop a project that work on insurance claim data set to detect fraud and fake claims amount. The project implement machine learning algorithms to build model to label and classify claim. Also, to study comparative study of all machine learning algorithms used for classification using confusion matrix in term soft accuracy, precision, recall etc. For fraudulent transaction validation, machine learning model is built using PySpark Python Library

Comparative Analysis ofK-Nn, Naïve Bayes, and logistic regression for credit card fraud detection

Introduction:This paper highlights the outcome of the comparative study of “Various Machine learning algo-rithms namely K-NN, Naive Bayes, and Logistic Regression for Credit Card Fraud Detection” carried out based on a dataset taken from UCI.com in 2022-23 at Manav Rachna International Institute of Research and Studies.Problem: Credit card fraud is still rife today and the modes are increasingly varied. Quite often we hear of fraud cases that cause irreplaceable injury to banks and financial institutions which cannot be compensated in terms of costs. To avoid scams with various modes of credit cards, we must be able to identify and find out the modes often used by fraudsters. This scheme liberates such financial institutions and banks with complete and appropriate information using Machine Learning Techniques, not only about the modes that scammers or fraudsters often use but also ways to protect against such frauds.Objective: The present paper discusses the various machine learning models based on classification and re-gression, namely K-Nearest Neighbors, Naïve Bayes, and Logistic Regression, which are successfully able to achieve the classification accuracy of 80% using Logistic Regression with a Precision of 78%, Recall of 100%, and F1-Score of 88% for fraudulent credit card transactions. Methodology: The comparative analysis demonstrates that for Precision, Recall, and Accuracy parameters, the K-Nearest Neighbor is a better approach for detecting fraudulent transactions than the Logistic Regression and Naïve Bayes. Results:The accuracy is marginal high in Logistic Regression but the False Positive parameters are not able to identify the imbalanced data; therefore, they disguise the results and accuracy of Logistic Regression and K-Nearest Neighbor deems fit for such cases.Conclusion: This scheme depicts the automated fraud classification systems using machine learning techni-ques, namely K-Nearest Neighbor, Logistic Regression, and Naive Bayes, to produce a model that can distin-guish valid and invalid credit card transactions.Originality:Through this research, the most relevant features are used to go through the visualization of accu-racy with the confusion matrix, and accuracy calculations are obtained from the dataset used.Limitations:Deep learning techniques could have been used to fetch even better results.

Analysis of IPO Fraud: Evidence from Amethystum Storage

The Science and Technology Innovation Board (STAR Market) was established on the Shanghai Stock Exchange and was officially listed on June 13, 2019. The establishment of the Science and Technology Innovation Board and the pilot registration system is a major reform measure of the capital market to enhance and serve the capabilities of technological innovation enterprises. With the increasing development of the capital market, IPO has become one of the important channels for corporate financing. Due to the more inclusive listing conditions on the STAR Market, more and more innovative companies choose to list on the STAR Market. However, the problems of IPO financial fraud are emerging one after another, showing the characteristics of initiative, systematic fraud, concealed means, huge amount, and long fraud cycle. It has adversely affected the economy and society. Hence, the article sorts out the financial fraud cases before and after the IPO of Amethystum Storage, a company listed on the Science and Technology Innovation Board last year, expounds the reasons for its IPO violations, and proposes from the perspective of securities companies. Countermeasures to prevent fraudulent listing of enterprises. These results shed light on guiding further policy implementation for IPO.

Pengaruh Corporate Governance dan Auditor Eksternal dalam Pencegahan Kecurangan Menggunakan Model Beneish dan Model OMI

Fraud cases have occurred since 2001. This has an impact on the decline in the world economy. In 2019, there was another decline in the world economy due to the Covid-19 outbreak which had an impact on reducing the quality of company financial reports. To prevent a decline in the quality of company financial reports which results in increased fraud, corporate governance and the quality of a company's external auditors must be improved. This study aims to empirically examine the role of corporate governance attributes, consisting of boards of directors, commissioners, audit committees, and institutional ownership, as well as the role of the quality of external auditors which is proxied by differences in Big 4 and Non Big 4 auditors in fraud prevention. The research sample is non-financial companies listed on the Indonesia Stock Exchange (BEI) during the 2017-2021 period, with observations of 307 companies. The regression method used to test the hypothesis is, the Beneish Model uses the logistic regression method with the help of SPSS ver 21 and the OMI Model uses the OLS regression method with the help of Eviews 12. The results of the research between the two regression models are that only the external auditor quality variable has a significant relationship with prevention. fraud. However, when tested using the logistic regression method, the variables that are significant in preventing fraud are institutional ownership and the quality of external auditors. Meanwhile, when tested using the OLS regression method, the research results showed that the variable that was significant in preventing fraud was the quality of the external auditor. So the use of the OMI Model in this research can strengthen the probability results of the Beneish Model to measure fraud in a company.

Uncovering Financial Fraud: The Vital Role of Forensic Accounting and Auditing in Modern Business Practice

Abstract This article explores the critical roles of forensic accounting and auditing in modern business, focusing on uncovering financial irregularities and promoting transparency. Through a meticulous literature review and analysis, the study emphasizes the significance of these practices. The purpose is to underscore their importance, methodologies, and implications. Methodologically, the article employs a comprehensive literature review and meticulous analysis of real-world applications. It investigates cases of corporate fraud, financial statement analysis, and dispute resolution. Ethical and legal considerations are highlighted, emphasizing the adherence to professional codes and standards. The study reveals that forensic practices are pivotal in detecting financial misconduct, upholding financial transparency, and ensuring accountability. Technological advances, such as data analytics and AI, enhance efficiency and accuracy. The research establishes the need for continuous development and professional education to tackle the evolving financial challenges. In summary, this article highlights the central roles of forensic accounting and auditing in modern business, their methodologies, and ethical considerations. The study underscores their importance in detecting financial fraud, promoting transparency, and fostering trust.

Changes of Civil Liability Risks of Audit Institutions under the Special Representative Litigation System——Take the Kangmei fraud case as an example

The new Securities Law proposes the concept of a special representative litigation system, increasing the efforts to protect the legitimate rights and interests of investors who are infringed upon, and the civil legal liability risks of audit institutions increase accordingly. To promote the healthy and orderly development of securities market and audit industry, this paper will take the Kangmei’s fraud case, the first case in which the special representative litigation system is applied, as the starting point, and analyze the civil legal liability of the audit institution in the case, so as to explore the changes of the civil legal liability of the audit institution under the special representative litigation system, and then put forward enlightenment and suggestions for the audit institution to achieve risk reduction.

In-Depth Understanding of Accounting base Financial Statement Fraud Detection Models

Financial statement fraud cases have increased rapidly during the last two decades. Early detection and prevention of fraud is needed to safeguard the interest of the investors and other stakeholders. Various fraud detection techniques are available to detect fraud such as machine learning, neural networks, data mining and artificial intelligence but there are accounting-based models are also available which also detect probable financial statement fraud using the information provided by the company in their financial reporting. This study provides a detailed understanding of accounting-based models such as Beneish M-score, Altman Z-score, and Dechow F-score which are helpful in predicting earning manipulation.

대규모 전세사기(빌라왕)에 대한 공법적 규제방안

Since the second half of last year, large-scale Jeonse lease fraud cases called “Villa King” and “Villa God” have been revealed one after another. The term “rental fraud” can be understood as “an act of stealing a lease deposit by deceiving a tenant (tenant) by those involved in a lease contract, such as a landlord (tenant), a builder, a broker, or a sales agent”. Most of the so-called “King of Villas” and “Billasin” defrauded tenants of their Jeonse lease deposits in a similar way, mainly targeting new villas or tenants of multi-family homes. The large-scale Jeonselease fraud occurred because of the difficulty in grasping the market price of new villas, the corruption of pre-sale agencies and licensed real estate agents, and the loopholes in the Jeonse lease loan and Jeonse lease guarantee insurance system. The problem of Jeonse lease fraud has existed before, but in recent years, Jeonse lease fraud has occurred nationwide and systematically because a large number of pre-sale agents, unqualified licensed real estate agents, and brokerage assistants have actively attracted tenants. Due to this Jeonse lease fraud, the Certified Brokerage Act was revised to prevent unqualified licensed real estate agents from operating, but there are no measures or regulations for sale agencies and real estate consulting companies. Therefore, it is hoped that the legislation for the sale agency business and real estate consulting business will be reorganized as soon as possible so that those with expertise and responsibility can mediate and protect the property of the people. The recent large-scale lease fraud is a complicated combination of insufficient tenant protection, guarantee insurance and lease loan system weaknesses, and legal and institutional problems of licensed real estate agents and real estate consulting companies. The large-scale Jeonse lease fraud has caused great pain and confusion, especially to the common people, and it also makes us think about the principles of private autonomy and the limitations of government intervention. The principle of private autonomy means that individuals can make their own decisions on matters related to them by respecting human dignity and values, and are also responsible for the decisions they have made. But no individual, no organization, no state is complete, and is free from unreasonable decision-making and unethical deviations and corrupt practices. And it grows through trial and error such as unreasonable decisions and corruption. I sincerely hope that the pain and confusion experienced by our society will be an opportunity to sublimate into an advanced housing welfare system and real estate transaction system.

Compensation of Moral Damage in Property Crimes

For a long time, the practice of criminal proceedings was based on the approach in which the moral damage in property crimes was not recognized by the bodies of preliminary investigation as a reason for civil law claims to compensate such damage as resulting from the crime. The conducted analysis of the opinions of different scholars showed that the overwhelming majority of proceduralists support the possibility of compensating moral damage in property crimes. The author pays special attention to a criminal case of fraud with intentional breach of contract in the sphere of entrepreneurship, where the bodies of preliminary investigation refuse to recognize the founder of the company that suffered property damage as the victim, and where the rights of the injured organization are represented by a bankruptcy trustee supervising the bankruptcy of the company. Using the decisions of the Constitutional Court of the Russian Federation on this problem, and the decrees of the Plenary Session of the Supreme Court of the Russian Federation, the author concludes that the procedural interest of the founder of the organization liquidated during criminal proceedings, and acting as the injured organization in the criminal case, consist in obtaining an independent procedural status of a victim, which gives this person an opportunity to actively participate in criminal prosecution, directly protect the rights and lawful interests or the injured organization alongside the bankruptcy trustee, and bring a civil action for the compensation of moral damage caused by the crime.

Forensic Accounting and Fraud Management in Government Owned Parastatal in Rivers State

Fraudulent practices among banks are major challenges facing the development of the industry. The federal government has been making several efforts in tackling these dreadful menaces by setting up many anti-corruption institutions to reduce cases of fraud and other activity of financial and economic crimes but the efforts seemed not to have yielded the desire results or have not been effective. This has put accounting professional bodies into a new perception and paradigm that go beyond statutory audit. The objective of this study focus on forensic accounting and fraud management, evidence from Nigeria, primary sources of data were appropriately used. 572 questionnaires were administered. The Researchers Use SPSS 21 to test the hypothesis to determine the F-value. The findings are that Forensic accounting significantly influences fraud detection and management. The researchers recommended that trained experts like the Professional Forensic Accountants should conduct the investigation, where there is evidence of fraud, appropriate disciplinary action in accordance with the Provision of rules should be implemented, and the restructuring of corruption agencies by the government for better performance. These agencies should have the will power and courage to perform optimally.

Financial Reporting Fraud and Models to Assist in Detecting Financial Statement Fraud

The article has used the methodology, analysis and synthesis to accomplish the set research objectives. Accordingly, based on the methodology, the article has presented the concept, purpose and importance of information provided in financial statements. Under many influences such as pressure to commit fraud, opportunities for fraud or management's attitude will lead to the intention to manipulate the financial statements. Next, the article also analyzes typical fraud cases, the impact of fraudulent financial statements on all financial market participants and identifies common forms of financial fraud in Vietnam. Vietnam. From these common types of fraud, the authors also propose two typical models to support fraud detection that are highly appreciated, the M-score model and the Z-score model.

Price transmission during food safety incidents: The case of Spanish tuna fraud

Using a two-regime threshold vector autoregressive model, this study investigates the nonlinear price transmission among tuna, salmon and hake during a food safety incident. The tuna fraud in Spain caused a histamine outbreak in 2017, which made 105 people fall ill. To evaluate the degree to which the food safety incident affected price transmission and reflected consumer awareness of the tuna fraud scandal, we have developed a communication index based on the number of Twitter posts and use its first difference to identify the increasing and decreasing regime of the development of the incident. There exists a greater reaction among prices in the increasing regime when communication strengthens on Twitter. Although the impacts of communication are not statistically significant, we find evidence that, in an increasing regime, a change in the communication index Granger causes the price of tuna and hake. The paper concludes with policy implications.

Douglas Mastriano Scandal

This case study looks at how a fraudulent PhD thesis from a Canadian university became entangled in US politics, attracting US and Canadian media attention. In 2013, Douglas Mastriano, a US Army colonel, was granted a History PhD from the University of New Brunswick (UNB) under unusual circumstances. A thesis committee member was removed without his consent, then informed by UNB that the thesis had been approved over his strong objections. UNB declared a 17-year-long embargo on public access to Mastriano’s thesis (it later admitted that its rules limit thesis embargoes to 4 years). In 2014, Mastriano published a book based on his thesis. Respected historians found multiple instances of academic fraud in it, including falsification of archival information. Scholars who requested access to Mastriano’s thesis were rebuffed by UNB. There matters might have rested. However, in November 2022 Douglas Mastriano ran for Governor of Pennsylvania. A Donald Trump supporter and participant in the Jan. 6, 2021 US Capitol invasion, he often cited his PhD from UNB during his campaign. Under media pressure, UNB released his thesis in October 2022. So far, 213 cases of serious academic fraud have been found in it. Before November 2022, UNB promised that “two independent investigators” would investigate Mastriano’s 2013 thesis and the 17-year-embargo on access to it. Subsequently, UNB has walked back that promise. Attendees will learn about the practical and ethical issues faced by a Canadian university when an old case of academic fraud unexpectedly becomes a source of controversy in the media.

Forensic Accounting in India- A Literature Review

Financial irregularities are a big concern on a global scale. It is also a major problem for developing nations like India. With the increase in financial crimes in India, the need for forensic accounting is becoming even more significant. This paper discusses the evolution of forensic accounting, its various techniques to detect financial fraud, and the future prospects of the forensic accountant profession in India. The current study is based on secondary data which is acquired from various research papers, reports, etc. It has been concluded that forensic accounting is a broader word that incorporates skills and competency in all areas of finance, knowledge of numerous fraud cases, awareness of corporate ethics, understanding of market dynamics, and investigative capabilities. With rising levels of corporate fraud and economic irregularities, it is expected that demand for forensic accountants will increase in the near future

Analisis Pengaruh Konsep Tri Kaya Parisudha Dan Sistem Pengendalian Internal Terhadap Kecenderungan Fraud (Kecurangan)

This research was motivated by a fraud case in the form of embezzling customer funds worth Rp. 14,027,000 from one of the collectors. The area of this exploration is in KSP. Panca Tirta Rauh during the reign of Gianyar. The reason for this study was to examine the impact of the Tri Kaya Parisudha concept and internal control system on the tendency of KSP fraud. Panca Tirta Rauh, Gianyar. This study utilizes quantitative methods. The review population consisted of his 70 from all employees at his five KSP branches. KSP. Panca Tirta Rauh consists of administrators, cashiers, lifeguards and collectors. The sampling technique utilized is a saturation sampling method with an example size of 70 respondents. Information were gathered by interview and survey strategies and accordingly broke down utilizing various straight relapse investigation methods. The results of this study indicate that 1) the concept of Tri Kaya Parisudha has a significant negative impact on fraud propensity (fraud); 2) The internal control system has a significant negative impact on fraud.

PENGARUH AUDIT INTERNAL, KOMPETENSI AUDITOR, KESESUAIAN KOMPENSASI DAN WHISTLEBLOWING SYSTEM TERHADAP PENCEGAHAN FRAUD

Fraud or commonly known as fraudulent activities carried out in various modes and continues to increase over time. The high number of fraud cases that occur in Indonesia must be taken very seriously, for example by forming an internal audit team that has a really valuable role in monitoring activities to determine whether programs and fraud prevention have been running effectively. This study plans to decide the impact of internal audit, auditor competence, compensation suitability and whistleblowing system on fraud prevention in the Inspectorate General of the Ministry of Maritime Affairs and Fisheries with a sample of 117 respondents. Data collected through questionnaires, the method used in this study is multiple linear regression. The results show that internal audit, auditor competence, compensation suitability and whistleblowing system have a significant effect on fraud prevention.

Unraveling the Mirage: The IL&FS Accounting and Financial Fraud Case Study

The IL&FS accounting and financial fraud case study delves into the downfall of Infrastructure Leasing & Financial Services, a prominent infrastructure development and finance company in India. The case study highlights the root causes of the fraud, including governance failures, inadequate risk management, and regulatory lapses. The fraud involved misleading financial reporting, masking the true financial position of the company. Eventually, defaults on debt obligations, downgraded credit ratings, and auditors' concerns led to the exposure of the fraud. The consequences were severe, with market disruptions, loss of investor confidence, and a liquidity crisis. The case study emphasizes the importance of robust corporate governance, transparent financial reporting, effective risk management, and strong regulatory oversight. It also explores the implications for various stakeholders and encourages discussions on lessons learned and strategies to prevent similar frauds in the future. The IL&FS case serves as a stark reminder of the need for ethical conduct, integrity, and accountability in the business world, leading to regulatory reforms and a stronger financial system in India.

Top Management Commitment and Insurance Fraud Cases Clearance among Life Insurers in Kenya

There is a modest amount of parenthesis literature that addresses the relationship between top management commitment and the extent of fraud case clearance among Life Insurance Companies in Kenya. The study was based the Administrative Management Theory. The theory has never been used extensively to understand the relationship between top management commitment and fraud case clearance hence this study made a significant theoretical contribution. The study adopted descriptive survey design that utilizes quantitative research to investigate the variables. Data was collected using questionnaires from the 21 life insurance companies with their head office based in Nairobi. Data collected was analysed using the latest Statistical Package for the Social Sciences (SPSS) version V28. Descriptive statistics such as frequencies and percentages were conducted to understand the rate of fraud case clearance. Inferential statistics such as Spearman correlation coefficient, , was also used to test the relationships. The results of correlation analysis from top management commitment yielded a mix of positive and negative correlation coefficients. Based on the findings of the present study, the life insurers management, their stakeholders, and the regulatory authority are better placed to achieve improved case clearance whenever there is top management commitment by management with regard to ethics when dealing with fraud allegations.