FRAUD REFERRAL SUPPORT
Fraud Referral Support
Organization of authorized investigative findings, source material, chronology, and supporting evidence for carrier, counsel, or agency referral workflows where the matter warrants referral.
BUYER LENS
Know what this service should answer before you scope it.
What factual question must be developed, documented, or resolved without turning the investigator into the claim decision-maker?
Good reasons to start here
- The file contains conflicting or incomplete facts.
- A witness, scene, activity, relationship, or chronology requires independent development.
- A suspicious or complex matter needs a defined investigative path rather than open-ended monitoring.
What to have defined
- The authorized investigative question and assignment purpose.
- Known parties, chronology, and relevant records already held by the client.
- Any jurisdiction, representation, contact, or escalation restrictions that govern the work.
What this should inform
A clearer factual record for the carrier, TPA, counsel, or other accountable authority to evaluate.
ACCOUNTABLE OWNERSIU, claims, counsel, or the authorized matter owner.CAPABILITIES
Disciplined support built around the matter.
MODLAN scopes each engagement to the authorized assignment, applicable requirements, available evidence, and client objectives. Work is documented for clarity, defensibility, and appropriate downstream review.
Referral package supportChronologySource attributionEvidence indexFinding separationReviewer handoff
WHEN THIS SERVICE FITS
Built around a defined operational question.
- An investigated matter may warrant referral to an authorized fraud bureau, law-enforcement, or other designated channel.
- The file needs organized supporting facts and evidence references before referral.
- The program wants a consistent documented referral workflow.
SCOPE
What the engagement can include.
The exact scope is established by the authorized assignment, applicable licensing or professional requirements, and client guidelines.
OPERATING MODEL
Controlled from assignment through handoff.
Qualify
Confirm the client-directed referral basis and applicable workflow.
Assemble
Organize the supporting investigative record without overstating conclusions.
Review
Check completeness against the client-approved referral requirements.
Track
Record submission and follow-up status in the approved system.
WORK PRODUCT
What the matter can produce.
- Referral-ready factual package
- Evidence/source references
- Submission status
- Follow-up record
CONTROL BOUNDARY
What keeps the work defensible.
- MODLAN does not promise acceptance or action by a receiving agency.
- Jurisdiction-specific reporting duties are confirmed for the actual program.
- Referral facts remain distinguishable from allegations or conclusions.
- Sensitive referral material uses approved secure channels.
SERVICE FAQ
Procurement and operating questions.
Do you decide whether a matter must be reported?
The client program and applicable legal/compliance requirements govern that decision; MODLAN can support the documented workflow.
Can you prepare the supporting record?
Yes, within the authorized engagement.
Can the referral be tracked?
The platform architecture supports auditable status and event records.
Does a referral mean fraud has been proven?
No. A referral communicates information for further review or action; it is not itself proof of fraud.
WHERE THIS SITS IN MODLAN
Special Investigations & Program Support
Develop facts, evidence, patterns, or program context for authorized SIU work.
Explore the operating family →SIUTechnology relationship
CST may support approved intelligence context while investigative conclusions remain human-reviewed and source-attributed.
View the full MODLAN service ecosystem →HOW THIS SERVICE CAN SCALE
From assignment to enterprise program—without changing who owns the decision.
A defined objective, scope, owner, evidence/data path, and handoff for a specific matter or task.
Recurring or overflow use of the same capability under established client rules, controls, and escalation paths.
The service becomes one governed lane inside a broader multi-service operating model with explicit dependencies.
PROCUREMENT & IMPLEMENTATION
Questions to resolve before this service enters production.
Enterprise delivery depends on the operating context around the service—not merely the capability itself.
PROGRAM FITSIU Program
Explore program architecture →See how this capability can operate as a matter, overflow resource, or governed SIU program component.
DECISION CONTEXT
This service does not operate in isolation.
The engagement should connect to the correct buyer, adjacent operating layer, and assurance boundary without blurring professional authority or the source of record.
ENTERPRISE JOURNEY
Connect this service to the rest of the operating model.
Move from service selection into the adjacent operational, evidence, integration, assurance, or intelligence layer that the matter actually requires.
MODLAN SYSTEMS
Bring the right people, evidence, and intelligence to the problem.
Contact MODLAN to discuss the authorized scope, geography, timing, and operational requirements for your matter.