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iGovern Fraud Investigation

The Situation Today

Determining eligibility for benefits claims can prove to be time consuming and difficult. The occurrences of incomplete or inaccurate information through the entitlements lifecycle raise the potential for fraud. Furthermore, the volume of information that needs to be verified often overwhelms the employees working on the case. Assessment of the risk associated with individuals and businesses before providing them with access to critical information is a critical challenge faced by the agencies.

How HCL Can Help

The iGOVERN® Fraud Investigation solution is part of HCL’s iGovern suite of citizen centric solutions and softwares, architected to deliver the services from a citizen’s point of view, enabling Government-to-Citizen (G2C) connect, and improved transparency and productivity.

iGOVERN® Fraud Investigation is a web-based solution for fraud case investigations in insurance and public welfare programs, which involves payment - such as food stamps, TANF and child care. This solution enables the Fraud Bureau of State agencies to effectively track and manage the investigation of frauds. The state agency receives complaints, investigate the cases, and processes criminal and/or civil proceedings. 

What You Can Expect

The key highlights of the iGOVERN® Fraud Investigation solution is:

  • Single unified interface for all fraud investigation functions - centralized and integrated
  • Ability to generate statistics and information to assist in reporting and in meeting regulatory requirements
  • Web-based multilingual E-Forms
  • Multi-layered security
  • Event Code Validation Rules Engine (CVRE)

iGOVERN® Fraud Investigation services to various stakeholders:

State Fraud Bureau

  • Capture complaints received via paper, email or fax
  • Generate acknowledgement letters
  • Case generation and link references
  • Manage investigative reports, plans, check lists, attachments, and evidence
  • Capture criminal events such as arrests, indictments, convictions, sentences, forfeiture and voluntary restitution
  • Propose civil fines to the subjects, receive payments or impose fines
  • Referral of cases and complaints to other governmental agencies
  • Annual reporting to the Governor
  • Provide referrals to other agencies

Prosecutors

  • Accept or decline cases for prosecution

Insurance Carriers / Law Enforcement Agencies/ Third Party Administrators

  • Online submission of insurance fraud complaints
  • Send follow up attachments to the complaints
  • Receive online alerts, case generation, and arrest
  • Online access to previously submitted complaints

Office of the General Counsel

  • Approve civil fines, conduct hearings and impose civil fines
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We will treat any information you submit with us as confidential. Please read our privacy statement for additional information.

We will treat any information you submit with us as confidential. Please read our privacy statement for additional information.