Fraud Definition

Fraud is defined generally as the wrongful or criminal act to deceive someone for one's own financial or personal gain. Legal definitions of fraud vary across countries, at the federal and state levels in the US, and even among states, but most have, at their core, the use of deception to make a gain by unlawful or unfair means. Many types of fraud exist, including occupational, operational, investor, accounting, credit card and insurance fraud, but all forms share the fact that the perpetrator knowingly receives a benefit to which they're not rightfully entitled. The purpose of fraud may be financial gain but also covers the acquisition of other benefits, such as obtaining a driver's license, a passport or other travel documents, or qualifying for a mortgage by using falsified documents or making false statements.

Fraud Screening

Fraud Screening generally refers to a checking system that identifies potentially fraudulent transactions. Fraud screening helps reduce fraudulent credit card transactions, reduce the number of manual reviews, minimizes risky sales, and improves a company’s bottom line.

Fraud Triangle

The Fraud Triangle is a simple framework that is useful to understand a worker's decision to commit workplace or occupational fraud. The fraud triangle consists of three components (sides) which, together, lead to the workplace fraud, and are: 1) a financial need, 2) a perceived opportunity, and 3) a way to rationalize the fraud as not being inconsistent with their own values. The Fraud Triangle is a common teaching aide and metaphor that has been used for decades.

Fraud Waste and Abuse

Fraud Waste and Abuse is typically a term most commonly used in government and healthcare and refers to several types of negligent and possibly criminal behavior. As defined by United States Code 1347, Fraud is “knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program; or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program.” It is illegal to knowingly submit false information in order to receive a monetary or other benefit, the definition of fraud. Waste and abuse, on the other hand, do not require intent and knowledge of wrongdoing. Abuse might take the form of a payment for items or services that have no substantiated basis for payment and/or for which the provider has not knowingly or intentionally tried to get paid. Waste usually refers to the inefficient use of services and is generally not the result of criminal negligence.

Friendly Fraud

Friendly Fraud can take many forms, but typically involves an actual consumer obtaining goods or services from a merchant, then claiming they did not make the purchase, did not receive the goods, or only received a fraction of items, in order to keep the goods or services without paying for them. Customers commiting friendly fraud make the purchase on a credit card, receive the product or service, and then demand a refund for a lost or short-shipped order, or file a chargeback through their credit card issuing bank, with the intention of receiving a full refund of purchase amount. Also referred to as chargeback fraud, it is estimated that $4.8 billion was lost by US businesses last year to friendly/chargeback fraud. It is also estimated that as much as 80% of all chargebacks are fraudulent.