{"revision":"c10276e953456835cdbb1f3a60d58ae1980be353","document":{"id":16034,"path":"financial-services-operations/insurance-claims/evaluate-claim-for-fraud.md","title":"Evaluate a commercial claim for fraud","bundle":null,"doc_type":null,"release":"australia","body":"\n# Evaluate a commercial claim for fraud\n\nA special investigations agent can review a claim to determine whether a claim is fraudulent.\n\n## Before you begin\n\nRole required: sn\\_ins\\_siu.agent\n\nUse the case playbook that provides the activities and tasks required to update and close the tasks of the claim case.\n\n## About this task\n\nWhen business rule logic identifies a claim case as a 'close proximity' claim- a claim case very close to the policy start date- then a task triggers to the SIU department for evaluation of fraud. An adjuster can also refer a claim for fraud evaluation during the adjuster's claim evaluation.\n\n## Procedure\n\n1.  Navigate to **All** &gt; **Financial Services Operations** &gt; **Workspace**.\n\n2.  Select the lists icon \\(\\[Omitted image \"inline-data-vis-96px-list.png\"\\] Alt text: lists icon\\).\n\n3.  Open the task from the special investigation tasks list.\n\n<table id=\"choicetable_bn1_2hs_25b\"><tbody><tr><td id=\"d62575e94\">\n\n**From the Special Investigation tasks list**\n\n</td><td>\n\n1.  In the **Lists** tab, under **Special Investigation tasks**, open the task list.\n    -   For your assigned tasks, select **Assigned to me**.\n    -   For all special investigation tasks, select **All**.\n2.  In the list, select the task that you want to work on.\n\n\n</td></tr></tbody>\n</table>    To work on a task that is not assigned to you yet, assign it to yourself by clicking **Assign to me**.\n\n4.  Finish the work that is required to complete the task in your claims system.\n\n5.  In the **Work notes** field, enter any comments that are related to your findings.\n\n6.  Close the task from the special investigation task form.\n\n    |Special investigation task|Action|\n    |--------------------------|------|\n    |**To submit a fraud evaluation**|Select **Approve** to conclude the claim as not fraudulent or **Reject** to validate the claim as fraud.|\n\n\n## Result\n\n-   If the task is approved, the task moves to Closed Complete.\n-   If the task is rejected, the task moves to Closed Rejected.\n\n"}}