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By Donald A. Kohtz
Most investigators love the hands-on aspect of investigations and the challenge of catching the fraudster. However, some investigators aren’t overjoyed about writing a case report that will be presented for criminal or civil prosecution.
The following checklist will provide structure and guidance in preparing a case report that will be submitted for state or criminal prosecution. it is equally applicable to case reports that will be used in civil litigation.
No matter what style or format is used, all reports should answer all of the important questions of who, what, when, where, why and how. The report should follow a logical order in presenting the sequence of events in the investigation. The investigative report basically tells a story.
1. Title or Cover Page
This helps identify the subject and tells the reader who prepared the investigative report.
2. Table of Contents
A table of contents provides a quick overview of the materials submitted. It should list the pages for all the sections of the report.
3. Synopsis
A synopsis is also called an introduction or executive summary.
A synopsis is a brief explanation of what happened in a case (it should outline the theory of your case). It should be no longer than a single page. it should catch the reader’s attention.
The explanation should cover the scheme, who was involved, the approximate time period and the amount of the loss (actual and potential).
This information sets the stage and serves as the introduction for the more detailed information contained in the following section of the evidence package.
4. Identifying Information
This section should provide any and all:
– Names used by the subject
– Aliases
– FEIN/Tin (tax identification number)
– Date(s) of birth
– Place of birth
– Social security number(s)
– Personal and business addresses, including the last known address
– Telephone numbers (home, office, cellular, FAX)
– Physical description
– Administrative (regulatory) fines and sanctions (licensing boards, etc.)
– Resume/Curriculum Vitae (obtained from credentialing, human resources)
– Any and all information that identifies the subject
5. Chronology
The purpose of a chronology is to establish the chain of events leading to the proof.
A chronology is helpful when analyzing a case.
Keep the chronology brief and only include information necessary to prove (substantiate) the case.
6. Witness Testimony (presentation of evidence)
This section is the “meat” of the report. It is also referred to as the “evidence section.”
It involves the compilation of all the relevant evidence – witness statements, confessions, admissions against interest, documents, etc. that you plan to use at trial.
Documents do not make cases – witnesses make cases.
This section should contain:
– All known individuals who have potential information regarding this case. Include full name, address, email and phone numbers.
– Indicate the nature of your contact with each witness and summarize his or her statement(s). Summarize the alleged fraudulent acts (scheme to defraud), explain the supporting documents, outline usual or unusual acts or items that show motive, greed, intent or responsibility. (Example: INTENT: altered records, fabricated documents, backdating records, withholding records, destroying records, suborn perjury; RESPONSIBILITY: specific authority to sign and file claim forms, the individual who provides oral or written instructions to employees, authority to hire and fire employees, authority to direct employees to perform work.)
– List (or reference, describe) the exhibits each witness will testify about.
7. Exhibit List
Exhibits should be presented in chronological order. Only one exhibit should be presented at a time.
8. Exhibits
Use photocopies of important documents to assure the availability of the originals. Certify photocopies as true copies (statement that the copy was compared to the original and that it is true and correct).
Examples of exhibits:
– Proof of Loss
– Personal Property Inventory
– Receipts, Proof of Purchase
– Insurance Application
– Declaration Sheet
– Schedule Page (declaration sheet in a health care fraud case)
– Fabricated records
– Altered Records, Altered Checks, Stolen Receipts
– Charge Card Receipts
– Estimates and Quotes
– Warranty Cards
– Photographs
– Video Surveillance (workers’ compensation, disability or employee theft)
– Draft/Check – provide original or certified copy Claim Forms (HCFA 1500 or similar documents)
– Medical Records EOB’s (Explanation of Benefits) – this shows how each claim was processed and what amounts were paid – Falsified prescriptions, diagnoses, patient charts
– Taped Statements
– Activity logs (notes, memos) – if written in code or with abbreviations, please provide an outline with a key.
9. Statements/Admissions
Include transcribed statements. Retain original videocassette tape until requested by the prosecutor.
Summarize all statements, written or verbal, made by defendants (subject of your investigation). These statements may be the result of formal interviews, sworn testimony, undercover conversations or unsolicited contact initiated by defendants.
Brady evidence: This reference is to the US Supreme Court case of Brady vs. Maryland. Brady requires the discovery or disclosure of all evidence favorable to the accused (exculpatory evidence) in a criminal case. Intentional suppression of material evidence favorable to an accused is a denial of Due Process, a constitutional violation.
If you have information or evidence, which is favorable to the accused, disclose it!
10. Visual Aids
Visual aids are invaluable in assisting the prosecutor and a jury to understand the evidence.
A picture is worth 1,000 words.
Examples of effective visual aids:
– Spreadsheets
– Link charts
– Flow charts
– Enlarged copies of actual documents: photos, claim forms, medical records
– Applications
– Time lines
– Video or tape recordings (use the subject’s own words to convict or obtain a defense verdict).
The visual aids should be accurate, simple (gets to the point), interesting (holds one’s attention), legible from the jury box (size does matter).
11. Recommendation/Conclusion
The report must be objective and based on the merits of the evidence. The recommendations should be obvious.
This section should contain the recommended charges and conclusions supported by witnesses’ statements and documentary evidence.
12. Staple or Bind Reports
Assemble the final investigative report with the witness statements, investigative reports, and all the exhibits in a neat and orderly package.
Use 3 ring binders, report jackets with 3 prong tabs, comb binding, or staples.
Do not rubber band your packet and hope it stays in order.
The Bottom Line
Outline your investigative findings in an organized format, list your witnesses, list your exhibits and attach your exhibits.
Your report should address the:
– issues
– crimes
– subjects/defendants
– elements of the offense
– cause of action/affirmative defenses
– evidence gathered to support suspicions
– recommendations and conclusions
Conclusion
A quality report should report all the facts accurately and be supported by testimony and exhibits (documents). The report should avoid an investigator’s personal feelings or opinions. Further, a quality report covers the elements of the offense, cause of action or affirmative defense by listing all the important facts and evidence concisely and thoroughly.
In summary, the investigative report functions as on outline during presentations of evidence and investigative findings during litigation. A clear, concise, and well-organized report is an integral part of a successful case.
Don Kohtz, former fraud bureau chief of the Nebraska Department of Insurance Fraud Division, now defends insurance companies from insurance fraud and provides advice on SIU issues. He can be contacted at Hansen, Engles & Locher, P.C., 402-348-0900 or www.hanengloc@navix.net
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