Question

1. where do most anti - fraud efforts occur?

a. at the state level
b. at the federal level
c. at the hands of the insurance industry
d. in local communities

1. which of the following is a correct statement about automated fraud detection?

a. automated methods of fraud detection prove that fraud has been committed.
b. automated methods of fraud detection do not prove that fraud has been committed.
c. automated methods of fraud detection are infallible.
d. claims can be considered fraudulent and denied based on automated methods of fraud detection.

Explanation:

1. For anti-fraud efforts related to insurance (a common context for such questions), the insurance industry itself conducts the majority of day-to-day anti-fraud work to protect their operations and customers.
2. Automated fraud detection systems only flag potential fraud by identifying anomalies or suspicious patterns; they cannot confirm that fraud has definitely occurred, as further investigation is always required.

Answer:

1. c. at the hands of the insurance industry
2. b. Automated methods of fraud detection do not prove that fraud has been committed.