Lighthouse Uncovers Key Evidence in Fast-Paced Employee Fraud Investigation

A Complex Employee Fraud Investigation 

The audit division of a health insurance provider was pursuing an internal investigation involving potentially concealed employee conflicts of interest with external vendors. The allegations involved possible defrauding of the parent organization through noncompliant contract and billing practices, as well as embezzlement of membership incentives for personal use and gain. With approximately 627K documents to review on an exceptionally tight timeline of two weeks, it was unclear how a comprehensive internal investigation would be completed to ensure proper due diligence. Counsel reached out to Lighthouse for help. 

Lighthouse Experts Quickly Uncover Key Evidence 

A small team of Lighthouse information retrieval, legal, data science, and linguistic experts immediately began working with counsel to understand the specific allegations at issue. As part of this work, the Lighthouse team catalogued the various sources of data that needed to be investigated. Based on counsel’s theory of the case, the team devised eight main search themes that would enable them to find instances of fraud or wrongdoing related to the allegations at hand. Over the course of the short two-week engagement, the Lighthouse team completed 22 discrete searches with corresponding deliveries based on expert analysis of the eight priority search themes. Each delivery was distilled down to include only the most inclusive, non-redundant versions of relevant documents so counsel wasn’t bogged down by reviewing a slew of duplicative and/or irrelevant documents.

Over the course of searching, Lighthouse experts quickly uncovered new key information that was previously unknown to counsel. This information revealed a picture of internal control gaps used to circumvent company policies, leading to problematic vendor contract arrangements and suspect billing practices. 

Separately, the Lighthouse team also uncovered details of relevant personal circumstances of targeted employees. This new information shed light on the potential motivation for bad acts, including substantial personal debt, resentment of parent company controls, and personal relationships with superiors in the management reporting structure.

Significant Risk Mitigation and Faster Investigation Resolution with Lighthouse 

In just two weeks, Lighthouse delivered a targeted set of approximately 16K documents, out of a total 627K in the review set. The Lighthouse deliveries represented everything counsel needed to know about the possible fraudulent employee activity—including concealed information that posed significant risk to the company if it had been left undiscovered. The team was able to accomplish this precision through deep subject matter expertise regarding the fraud allegations, comprehensive metadata analysis and emotional content detection, consistent and effective communication with counsel, expert topic-based searching, and exhaustive content deduplication.

With Lighthouse’s partnership, counsel quickly gained a thorough understanding of the internal controls, potential fraud, and the embezzlement issues at play—ultimately enabling them to significantly mitigate risk and complete their investigation in just
two weeks.