The Deceiver
The Deceiver makes others believe something that is not true to dishonestly gain personal benefits.
This might involve:
- providing false statements
- deliberate misrepresentation of facts or circumstances
- withholding relevant information for personal gain.
Examples:
- An individual misrepresents facts or circumstances to receive a welfare benefit.
- A vendor withholds relevant information to win a contract.
Case studies
A Queensland doctor was found guilty of defrauding Medicare out of more than $360,000. He used Medicare’s online system to lodge almost 4,000 false claims for providing services to patients who had died or on dates when he was overseas. The doctor owned four bulk-billing medical practices in Queensland at the time of the fraud. The man was sentenced to 4 years in prison. He was suspended from medical practice and might be deregistered or banned in the future.
A Melbourne woman was convicted of fraud after using $600,000 worth of resident’s deposits from an Aged Care facility. The company went into liquidation shortly afterwards leaving 42 residents without a home and debts of $4.5 million. She deceived residents when she told them their deposit money would be held in a trust account and that interest gained from the money would be used to reduce accommodation fees.
Countermeasures
Counter the Deceiver using measures that support honesty, integrity, information sharing and verification:
Use declarations or acknowledgments to both communicate and confirm that a person understands their obligations and the consequences for non-compliance. The declaration could be written or verbal, and should encourage compliance and deter fraud.
Make sure requests or claims use a specific form, process or system for consistency.
Have clear and specific eligibility requirements and only approve requests or claims that meet the criteria. This can include internal requests for staff access to systems or information.
Make sure forms or system controls require mandatory information to support claims or requests.
Apply limits on requests, claims or processes, such as maximum claim amounts or time periods. Enforce these limits using IT system controls.
Verify request or claim information you receive with an independent and credible source.
Automatically match data with another internal or external source to obtain or verify relevant details or supporting evidence. This countermeasure is supported by the Office of the Australian Information Commissioner's Guidelines on data matching in Australian government administration.
Require clients, staff and third parties to have ongoing compliance, performance and contract reviews.
Train and support staff to identify red flags to detect fraud, know what to do if they suspect fraud and know how to report it. Fraudsters can take advantage if staff and contractors are not aware of what constitutes fraud and corruption.
Put in place processes for staff or external parties to lodge tip-offs or Public Interest Disclosures.
Reconcile records to make sure that two sets of records (usually the balances of two accounts) match. Reconciling records and accounts can detect if something is different from what is standard, normal, or expected, which may indicate fraud.
Conduct internal or external audits or reviews to evaluate the process, purpose and outcome of activities. Clients, public officials or contractors can take advantage of weaknesses in government programs and systems to commit fraud, act corruptly, and avoid exposure.
Fraud detection software programs automatically analyse data to detect what is different from what is standard, normal, or expected and may indicate fraud or corruption.
These are penalties for customers, staff or third parties that commit fraud or do not comply with rules, processes and expectations.