Someone who dishonestly gains a personal benefit by preventing their actions from being seen or known about.
This might involve hiding their activities or covering their tracks for dishonest gain or to evade detection.
Recent case studies
- A medical clinic owner defrauded the Commonwealth of more than $3.3 million by claiming rebates for services not rendered. In order to avoid detection from employees of the clinic, including the health practitioners, he deleted the claims from the clinic's practice management software, shortly after submitting them. He pleaded guilty to six charges of fraud under the Criminal Code 1995 (Cth).
The methods of the concealer are countered by measures that support oversight and transparency.
Key countermeasures include:
- Managerial, independent or expert oversight
- Staff and contractor rotation
- Data matching
- Segregation of duties are applied
- Requests, claims or activities are approved by the appropriate decision-maker
- Quality assurance checks
- Automatic notification of high-risk activities and transactions
- Reconciliation (accounting)
- Activity reporting
- Internal or external audits or reviews
- Fraud detection programs
- Documentation and evidence storage
- Audit logging
- Video or electronic surveillance
- Trained fraud analysts and investigators.
Other effective countermeasures may include:
- Governance, accountability and oversight
- Integrity checks and suitability reviews
- Self-disclosure and reporting mechanisms
- Data protected from manipulation or misuse
- Data analytics
- End of life processes
- Staff are trained and supported to identify and report fraud and corruption
- Tip-offs and Public Interest Disclosures
- Exception reporting
- Incident reporting
- Fraud investigations.
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