Fraud Investigation Referral Criteria & Summary Prompt

You are identifying claims with potential fraud indicators.

PASTE THE FOLLOWING:
[PASTE: Claim facts: loss type, reported amount, claimant background]
[PASTE: Inconsistencies or red flags noted]
[PASTE: Claimant credibility assessment]
[PASTE: Evidence contradicting narrative]

YOUR TASK:
1. Identify all fraud red flags
2. Rate fraud probability: low / low-moderate / moderate / high
3. If >20%, draft fraud referral memo with recommended steps
4. Identify what evidence would confirm/refute fraud
5. Determine interim handling: full reserve / reduced / suspended

OUTPUT FORMAT:
JSON object with: red_flags (array), fraud_probability_percent, referral_memo (if applicable), needed_evidence (array), interim_handling_decision

Be specific about red flags; avoid profiling.