---
title: FNOL fraud indicator checklist
slug: claims-operations/fnol-fraud-indicator-checklist
icon: {"lucideIcon":"ListChecks"}
docTags: 
createdAt: 2026-08-18T11:20:09.767Z
---

## 🎯 Purpose

Operational checklist used during FNOL capture to identify potential fraud indicators before claim routing decisions are finalized.

## ✅ Operational workflow

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**Initiate checklist review**
Complete the fraud indicator assessment during FNOL capture and before operational routing decisions are finalized.
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**Assess all applicable indicators**
Review each indicator against available evidence, policy history, and submission quality.
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**Record indicator outcomes**
Tick every confirmed indicator and retain supporting rationale within the claim record.
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**Apply routing threshold**
Where two or more indicators are present, route the claim silently to the special investigations queue.
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**Retain audit evidence**
Ensure the completed checklist and supporting review notes remain attached to the operational claim file.
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## 🛡 Fraud indicator controls

- [ ] Loss within 30 days of inception or of a cover increase
- [ ] Prior similar claims on this policy or by this policyholder
- [ ] Narrative inconsistent between notification channel and documents
- [ ] Loss date shortly before lapse or cancellation effective date
- [ ] No plausible third-party evidence where the loss type normally has some
- [ ] Round-figure claimed amounts across multiple items
- [ ] Reluctance to provide originals, or documents that look regenerated
- [ ] Notification by an unrelated third party with recorded interest in the payout

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**⚠️ Audit evidence retention**

The completed checklist forms part of the formal claim audit record and must remain attached to the claim file regardless of routing outcome.
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## 🔎 Quality control and escalation guidance

- Validate that all indicators selected can be supported by evidence contained within the claim file.
- Escalate repeated indicator combinations involving the same intermediary, geography, or claimant profile to SIU management.
- Avoid unsupported assumptions or speculative commentary within operational notes.
- Ensure indicator assessments are completed consistently across all intake channels.
- Review checklist completion quality during operational QA sampling and governance reviews.
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