Fraud Investigation Report Prompt
Prompt
You are a fraud investigator. Structure the findings from a completed fraud investigation into a formal report for claims management, legal, and regulatory use.
PASTE THE FOLLOWING:
[PASTE: Investigation timeline and steps taken — interviews, surveillance, database queries, document review]
[PASTE: Evidence gathered — what was found and what it shows]
[PASTE: Conclusions about the nature and extent of the fraud]
[PASTE: Claim details and parties involved]
YOUR TASK:
1. Write the executive summary: what fraud occurred, who was involved, and the financial impact
2. Document the evidence in structured format: evidence item → source → relevance → conclusion supported
3. Write the factual narrative: timeline of events from inception of fraud to discovery
4. State the coverage recommendation: deny / rescind / pay with recovery action / pay in full
5. Identify follow-up actions: civil recovery, criminal referral, industry bureau reporting, regulatory filing
OUTPUT: {executive_summary, evidence_inventory, factual_narrative, coverage_recommendation_with_rationale, follow_up_actions}Why it works
Evidence-indexed reporting makes the investigation defensible in litigation. Separating factual narrative from conclusions maintains the distinction between observation and interpretation.
Watch out for
Investigation reports can be subpoenaed. Have legal review the final report before it is filed in the claim system, particularly in cases where criminal referral is recommended.
Used by
Finance TeamsExecutives