Fran, who has made multiple insurance claims in the past, submits a fire loss claim.

The red flag is that Fran has made multiple insurance claims in the past. Prior claims history can indicate a pattern of suspicious or repeated losses, especially when a new claim involves valuable property. Receipts and photographs generally support a claim rather than create suspicion by themselves, although they should still be verified for authenticity. Including bulky items in a fire loss claim is not automatically suspicious because fires can destroy many types of property, including large household goods. The ACFE insurance fraud materials identify red flags as indicators requiring further review, not proof of fraud. Fran’s repeated claim history would justify closer examination of the claim details, supporting documentation, timing, policy coverage, and any prior loss patterns.

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