In the comments to a previous post a practitioner writes
Fraud staff only get involved when a claim is referred to them. I regularly process claims which I think are suspicious, I cant do anything else without proof. As single parent fraud appears to be the easiest then more should be done when a child is born and more spot checks on live claims. But my manager wants claims to be processed as quickly as possible because that is how we are judged. I have always said that 'mystery shoppers' should make fraudulent claims and then see how many get paid. The results would be staggering!