Series One: How Knowledge of Psychological Counselling Makes You an Efficient Interviewer in Fraud Detection Interviews
Fraud investigation is often viewed as a technical process—verifying documents, analysing data, and identifying inconsistencies. Yet, every claim investigation ultimately revolves around human behaviour. Before introducing counselling principles into fraud examination interviews, it is essential to understand how counselling itself is structured and why that structure is relevant to investigative interactions.
The Counselling Model: Exploration, Understanding, and Action (EUA)
Psychological counselling is not an unstructured conversation. It follows a well-established model designed to help individuals express, clarify, and eventually address issues. One of the most practical and widely applicable frameworks is the EUA model:
1. Exploration
This stage focuses on allowing the individual to express their narrative freely. The counsellor listens without judgment, interruption, or premature conclusions.
2. Understanding
Here, the counsellor works to make sense of the narrative—identifying emotions, motivations, inconsistencies, and underlying concerns.
3. Action
Only after exploration and understanding does the counsellor move toward solutions, confrontation, or behavioural change.
This sequence is critical. Skipping stages often leads to resistance, denial, or disengagement.
Why the EUA Model Matters in Fraud Examination Interviews
Fraud examination interviews often fail not because evidence is weak, but because the interaction is poorly sequenced. When investigators move too quickly to confrontation or conclusions, interviewees become defensive and guarded.
Applying the EUA model ensures that:
- Information is gathered before evaluation
- Behaviour is observed before interpretation
- Evidence is introduced at the right moment
In essence, EUA transforms interviews from confrontational exchanges into structured behavioural assessments.
Why Order Is Important (Simple Example)
Imagine asking a patient:
“Why didn’t you take medicines properly?”
Before knowing:
- What illness they had
- What medicines were given
- Whether they could afford them
The patient may feel blamed and stop talking.
The same happens in insurance interviews.
Understanding the “Frame of Thought”
A key counselling concept relevant to investigations is the Frame of Thought. This refers to how an individual internally interprets events based on:
- Personal beliefs
- Past experiences
- Social and cultural conditioning
- Perceived risks and rewards
Two people may experience the same event but describe it very differently. In fraud interviews, misunderstanding this frame can lead to incorrect assumptions about intent.
For example:
A claimant speaks angrily during interview.
Investigator thinks: “He is hiding something.”
BUT Reality: He is scared the claim will be rejected.
Understanding the frame of thought allows the interviewer to interpret responses accurately, rather than react emotionally or prematurely.
From Counselling to Claim Investigation Interviews
Once the counselling model is understood, its application to fraud interviews becomes intuitive. A claim investigation interview is most effective when it follows the same psychological sequence.
Stage 1: Initiating (Aligned with Exploration)
The initiating phase sets the psychological foundation. Here, the interviewer:
- Clarifies the purpose of the discussion
- Establishes neutrality and professionalism
- Reduces anxiety without reducing seriousness
This stage encourages openness and prevents early psychological shutdown.
Example
This is how the interview starts.
Wrong Way
“We have doubts about your claim.”
This creates fear.
Right Way (Health Claim Example)
“We are reviewing your claim to understand the treatment better.
Please help us understand what happened.”
This makes the person comfortable.
Stage 2: Responding (Deep Exploration)
In this phase, the interviewer listens more than speaks. Techniques include:
- Open-ended questions
- Reflective listening
- Allowing silence
This enables the interviewee’s natural narrative patterns to emerge—often revealing more than direct questioning.
Example
Question:
“Can you please tell me, from the beginning, when the illness started?”
The investigator:
- Does not interrupt
- Allows pauses
- Notes details
Truthful person: speaks smoothly
False story: changes details, jumps timelines.
Stage 3: Personalising (Moving Toward Understanding)
Personalising shifts the narrative from general statements to individual accountability:
- “What steps did you personally take?”
- “How did you understand this requirement?”
This stage helps identify:
- Ownership
- Avoidance
- Emotional discomfort
It is here that ego defence mechanisms often surface.
Example
General question (wrong approach):
“How do accidents usually happen at your workplace?”
Personal question (correct approach):
“What exactly were you doing at that moment?”
This helps to see:
- Whether the person owns the story
- Whether they avoid responsibility
Understanding Ego Defense Mechanisms (In Simple Words)
When people perceive threat, the mind activates unconscious protections called ego defence mechanisms. Common ones in fraud interviews include:
- Denial – refusal to accept facts
- Rationalisation – justifying questionable actions
- Minimisation – downplaying seriousness
- Projection – shifting blame to others
These responses do not prove fraud—but they signal psychological pressure points worth observing.
Common Defences with Examples
1. Denial
“No, this is wrong.”
Life Insurance Example:
Nominee refuses to accept that death happened before policy waiting period.
2. Rationalisation
“Everyone does this.”
Health Claim Example:
Claimant says: “everyone have hypertension today. What’s the big issue, if I’ve not mentioned the same in proposal form?.”
3. Minimisation
“It’s a small thing.”
Personal Accident Example:
“I forgot to mention that I was drinking. It was just one drink.”
4. Projection
“Someone else made me do it.”
Health Claim Example:
“Hospital staff filled the form, not me.”
These do not prove fraud, but show mental pressure.
Stage 4: Confrontation (The Action Phase)
In counselling—and in fraud interviews—confrontation belongs in the action stage, not at the beginning.
Effective confrontation:
- Story is fully told.
- Details are noted.
- Evidence is ready.
Correctly timed confrontation often leads to:
- Clarification
- Correction
- Inadvertent disclosure
Poorly timed confrontation leads to silence, hostility, or rehearsed responses.
Emotional Regulation: Managing the Investigator’s Frame of Thought
Counselling also emphasises awareness of the interviewer’s (investigator in our case) own frame of thought. Bias, frustration, or moral judgement can distort interpretation.
An emotionally regulated interviewer:
- Maintains neutrality
- Observes behaviour without reacting
- Allows inconsistencies to surface naturally
This self-control is not passive—it is investigative discipline.
Life Insurance Example
Nominee is crying and confused.
Good investigator:
- Stays calm
- Slows interview
- Allows breaks
This gets better information later.
Ethics as a Strategic Advantage
Counselling-based interviewing is grounded in ethics—respect, dignity, and fairness. In fraud investigation, this approach:
- Improves statement reliability
- Reduces disputes and complaints
- Strengthens legal defensibility
Ethics are not a constraint; they are an investigative asset.
Conclusion: Behaviour Before Conclusions
Applying counselling psychology to fraud investigation does not replace evidence—it reveals how evidence is constructed, defended, or distorted by human behaviour.
By understanding the EUA model, recognising the frame of thought, and sequencing interviews correctly, investigators move from pressure-driven questioning to insight-driven interviewing.
In the next article of this series, we will examine stress responses, memory construction, and cognitive load, and how they influence truth and deception in insurance interviews.
Because effective fraud detection begins not with confrontation—but with understanding.