International Fraud Awareness Week 2025: Managing Fraud Risk in Mexico

How insurers, clinics, law firms, and corporate teams with exposure in Mexico can use Fraud Week 2025 to reduce fraud risk in real operations.

Author: Fahad Hizam, CAMS, CFCS, ASIS APP – GrayCat PI, licensed private investigator in Mexico
Organization: GrayCat PI – financial crime investigations and corporate security solutions in Mexico

From 16 to 22 November 2025, International Fraud Awareness Week focuses attention on one fact many leaders prefer not to think about. Fraud is common, costly, and often preventable when you act early. For organizations that operate in or with Mexico, the risk is shaped by complex supply chains, health systems, cross-border payments, and local intermediaries.

We work with insurers, clinics, law firms, and corporate clients that need fraud detection services, financial crime investigations in Mexico, and practical corporate security solutions. During Fraud Week 2025, our goal is to turn global fraud data into clear, local actions you can apply to your own claims, contracts, and operations.

Key fact: Certified Fraud Examiners estimate that a typical organization loses about 5% of its annual revenue to occupational fraud, based on analysis of 1,921 real cases from 138 countries in the ACFE report Occupational Fraud 2024: A Report to the Nations. Source: ACFE summary

This article explains why Fraud Week matters for organizations with exposure in Mexico, where fraud tends to appear, and what concrete steps you can take this week to strengthen your defenses with support from GrayCat PI.

In the next section, we explain what International Fraud Awareness Week is and how it connects to the fraud risks you face in Mexico.

What Is International Fraud Awareness Week?

International Fraud Awareness Week is a global campaign created by the Association of Certified Fraud Examiners (ACFE) in 2000. It encourages organizations to focus, at least once a year, on fraud prevention and fraud detection in their own operations. During this week, business leaders, public agencies, and non-profits are invited to share resources, host training, and speak openly about fraud risk and control gaps. Source: ACFE – Fraud Week

In 2025, Fraud Week takes place from 16 to 22 November. Supporters include banks, insurers, government agencies, universities, and many private companies. They use the week to launch internal campaigns, run fraud risk assessments, and review how tips and complaints are handled. Source: ACFE – Supporting Organizations

Key fact: The ACFE estimates that tips are the most common way to detect occupational fraud. In the 2024 report, 43% of cases were detected by a tip, which is more than three times any other detection method.

As a Supporting Organization, GrayCat PI uses Fraud Week to bring this global conversation into the specific context of Mexico. We focus on sectors where we work every week: insurance claims, health services, and corporate operations with local partners. This focus allows us to connect international best practices with real constraints on the ground, including local law, evidence standards, and data access.

In the next section, we look at the main fraud risks we see in Mexico for insurers, clinics, law firms, and corporate clients.

Key Fraud Risks for Organizations with Exposure in Mexico

Fraud in Mexico does not follow a single pattern. It appears in claims, billing, procurement, payroll, third-party contracts, and asset use. When you work with insurers, clinics, or corporate operations that touch Mexico, you face both “classic” occupational fraud and local risks linked to weak controls, informal practices, and complex payment chains.

We focus here on three broad areas where we see recurring problems in financial crime investigations in Mexico: insurance and claims fraud, fraud in clinics and health providers, and corporate and legal risks linked to vendors, partners, and internal staff.

1. Insurance and Claims Fraud

• Inflated or fabricated claims. Overstated damages, staged accidents, or injuries that do not match medical evidence, often supported by weak or recycled documentation.
• Provider collusion. Networks of clinics, adjusters, and intermediaries that coordinate invoices for unnecessary or nonexistent services, or that reuse the same diagnostics across different cases.
• Identity and policy fraud. Use of false documents, straw insureds, or misrepresented risk data to obtain coverage or push claims.

Key fact: In the ACFE’s global study, 86% of occupational fraud cases involved asset misappropriation, and the median loss per case was USD 145,000. Many of these cases affected insurance, banking, and related financial services.

For insurers with exposure in Mexico, these schemes often mix weak internal controls, limited on-the-ground verification, and relationships between local staff and external providers.

2. Fraud in Clinics and Health Providers

• Billing for services not provided. Medical records and invoices show consultations, tests, or procedures that never happened or that were performed on a different patient.
• Upcoding and unbundling. Systematic use of higher-priced codes or separation of services that should be billed together in order to increase revenue per patient.
• Procurement and supplier schemes. Clinics repeatedly buy from the same supplier at above-market prices, or accept “free” equipment in exchange for channeling patients, tests, or prescriptions.

In our investigations, we often see that these patterns are visible in billing data for months before anyone acts. A simple review of outliers by provider, code, or region can highlight where to focus checks or site visits.

3. Corporate and Legal Risks

• Expense and procurement fraud. Ghost vendors, false invoices, and kickbacks linked to staff who steer contracts toward “preferred” suppliers, sometimes connected to them or their families.
• Asset misappropriation. Skimming of cash, manipulation of inventory records, or use of company assets for personal gain without proper approval.
• Third-party and intermediary risk. Local partners, agents, or distributors involved in bribery, conflicts of interest, or diversion of funds, often in sectors with high contact with public entities.

Key fact: The ACFE reports that more than half of occupational fraud cases arise in either private companies or public entities, and that weak internal controls or override of existing controls are cited as the primary enabling factor in most schemes.

When you add cross-border payments, local intermediaries, and different legal expectations, these general patterns translate into specific exposure for organizations that work in or with Mexico. In the next section, we will look at common red flags that signal when these risks may already be active inside your organization.

Common Fraud Red Flags You Should Not Ignore

Most fraud cases leave signals before they are formally detected. These signals do not prove misconduct on their own, but they tell you where to look more closely. During Fraud Week, you can use this list to review your own claims, billing, vendors, and internal processes in Mexico.

1. Patterns in Data and Documents

• Unusual spikes or clustering. Claims, refunds, or invoices that increase sharply in a short period, especially from one clinic, region, or vendor.
• Repeating details. The same diagnosis codes, treatments, contract amounts, or descriptions repeated across many different files.
• Weak or inconsistent records. Missing signatures, altered documents, handwritten changes without explanation, or documents that do not match what is in your systems.

When these patterns appear in your data, they are a sign that you should perform deeper checks, request more evidence, or consider a focused fraud review.

2. Behavioral Red Flags in Staff and Partners

• Resistance to basic controls. Employees who refuse to share access, avoid segregation of duties, or insist that only they can work with certain clients, clinics, or vendors.
• Unusual lifestyle changes. Sudden visible spending that does not match salary level, combined with control over money, billing, or contracting processes.
• Frequent rule bending. Staff or partners who often ask for exceptions, work around approval chains, or treat policies as optional.

Key fact: In ACFE case data, many fraudsters show at least one behavioral warning sign, such as living beyond their means, having financial difficulties, or having unusually close ties with vendors or customers.

3. Vendor, Partner, and Third-Party Concerns

• Opaque ownership. Vendors or intermediaries where ownership is unclear, addresses are shared mailboxes, or legal records do not match what staff say.
• No competitive process. Repeated awards to the same supplier without market testing, especially when price, quality, or delivery performance are weak.
• Conflicts of interest. Hints that employees or their family members may control or benefit from a vendor, clinic, or other third party, without any formal disclosure.

These issues are especially important in Mexico when you depend on local agents, brokers, or distributors to handle government-facing or high-cash activities.

4. Complaints, Tips, and “Whispers”

• Anonymous messages. Hotline reports, emails, or informal messages that point to a specific person, unit, or provider.
• Staff concerns. Employees who quietly mention that something “does not feel right” with a process, clinic, or vendor, especially when more than one person raises the same topic.
• External feedback. Clients, patients, or counterparties who complain about invoices, billing practices, or how a local contact is acting.

If you see these red flags in your organization, the next step is not to panic. The next step is to decide how to review the facts, preserve evidence, and, when needed, bring in independent fraud detection services or financial crime investigations in Mexico.

In the next section, we outline practical actions you can take during Fraud Week 2025 to respond to these red flags and strengthen your anti-fraud controls.

Practical Actions You Can Take During Fraud Week 2025

You do not have to redesign your entire control framework in one week. Instead, you can use International Fraud Awareness Week to make a few focused changes that will keep reducing fraud risk over the next months. In this section, we focus on actions that are realistic for insurers, clinics, law firms, and corporate teams with exposure in Mexico.

Start With Five Core Anti-Fraud Actions

If you only have a few hours during Fraud Week, focus on these five steps first. They are simple, but they create a base for more advanced work later.

1. Review and update your ethics and anti-fraud policy.
   Make sure you have a clear written policy that states your position on fraud, conflicts of interest, and misuse of company assets. Check that it applies to employees, managers, and third parties where relevant. Confirm that staff know where to find it and that it exists in Spanish for teams in Mexico.
2. Clarify who owns fraud risk.
   Identify one senior person who is responsible for fraud risk across your operations. Then make it clear that local managers in Mexico are responsible for fraud risks in their units, including clinics, branches, or projects.
3. Map your highest-risk processes in Mexico.
   List your top three processes where fraud would cause the most damage and be hardest to detect. For example, claims handling, medical billing, procurement, or local agent contracts. Note who approves what, which systems are used, and where controls are weak or bypassed.
4. Check whether your reporting channels really work.
   Confirm that employees, providers, and partners know how to report concerns and that they can do so without retaliation. Test your hotline or webform. Check response times and how information is logged and escalated.
5. Run one focused training or briefing.
   Instead of a long generic webinar, choose one group and one topic. For example, a 45-minute session with claims staff on red flags in Mexican medical invoices, or a session with legal and procurement on third-party risks.

These steps do not require major software or long projects. They do require clear decisions, communication, and basic follow-up after Fraud Week ends.

Use Data You Already Have

Most organizations already hold data that can show early signs of fraud. During Fraud Week, you can run simple checks that do not need advanced analytics:

• Sort recent claims, invoices, or contracts by amount and review the top 20 items with a small team.
• Identify the clinics, vendors, or intermediaries that receive the most payments in Mexico and check whether contracts, KYC files, and approvals are complete.
• Compare billing patterns for similar providers or regions to see who stands out and why.

Even a short review can reveal obvious anomalies and help you decide where to focus more detailed fraud detection services or financial crime investigations in Mexico.

Communicate Clearly With Your Teams

Fraud prevention depends on people, not just controls. Use Fraud Week to send a short, clear internal message that:

• States that fraud and corruption are not acceptable.
• Explains how to report a concern, including anonymous options where they exist.
• Confirms that retaliation against whistleblowers is not allowed and will be taken seriously.

This message should come from senior leadership and be consistent across languages and locations. It does not need complex wording. It needs clarity and follow-through.

In the next section, we will look at the ACFE Fraud Prevention Check-Up and how you can use it as a simple tool to assess your current fraud controls and set priorities for the next quarter.

Use the ACFE Fraud Prevention Check-Up

If you only have a few hours during Fraud Week, this is one of the most useful tools you can put in front of your team. The ACFE Fraud Prevention Check-Up gives you a structured way to see how exposed your organization is to fraud and where you should act first.
According to Occupational Fraud 2024: A Report to the Nations, organizations lose an estimated 5% of revenue to fraud each year, with a median loss of USD 145,000 per case and losses of at least USD 1 million in 22% of cases.

What is the Fraud Prevention Check-Up?

The Fraud Prevention Check-Up is a free questionnaire created by the Association of Certified Fraud Examiners. It reviews the “health” of your anti-fraud controls in seven areas and gives you a score up to 100 points. Source: FraudWeek.com resources

• Fraud risk oversight. How your board or owners supervise fraud risks.
• Fraud risk ownership. Who in senior management is clearly responsible for fraud risk.
• Fraud risk assessment. How often you identify and update your main fraud risks.
• Risk tolerance and policy. How you define which risks are acceptable and which are not.
• Process-level controls. How you prevent and detect fraud in high-risk processes.
• Environment-level controls. Tone at the top, ethics, training, and reporting channels.
• Proactive detection. Tests and reviews designed to catch fraud early.

The full questionnaire and scoring guidance are available in the original ACFE Fraud Prevention Check-Up document. Source: ACFE Capítulo México – Herramientas (Fraud Prevention Check-Up)

How to use it during Fraud Week

You do not need to turn this into a large project. For many organizations in Mexico, a focused half-day session is enough to get value from the tool.

1. Form a small group. Include at least one senior manager, someone from finance or internal control, and a person who knows day-to-day operations well.
2. Download the Check-Up. Access the resource through the ACFE or your local chapter, and keep one copy for notes and one clean copy for records.
3. Score each question honestly. Use recent experience, not only formal policies. If a control exists only on paper, score it low.
4. Agree on the three weakest areas. Look for scores that are clearly below others, especially in oversight, environment, and detection.
5. Turn weak areas into simple actions. For each low score, write one concrete step you will take in the next 90 days.

This exercise helps you move from general concern about fraud to a short, concrete list of priorities that you can explain to executives, owners, and auditors.

Where GrayCat PI can support

If you prefer an independent view, we can facilitate the Fraud Prevention Check-Up as an external partner. We bring experience from fraud and financial crime investigations in Mexico, and certifications such as CAMS, CFCS, and ASIS APP, to help you interpret results and focus on practical improvements rather than theory.
You can learn more about our work at https://GrayCatPI.com.

In the next section, we will look at real-world fraud patterns we see in Mexico so you can connect these scores to concrete risks in claims, clinics, suppliers, and third parties.

Real-World Fraud Patterns You Should Not Ignore

Statistics are useful, but they only matter when you connect them to real behavior on the ground. In Mexico, fraud risk often concentrates around a few sensitive areas. Here we highlight patterns we see often in our work and in public cases that should be on your radar if you manage operations, assets, or clients connected to the country.

Health, Public Procurement, and Collusion Risks

Independent research has shown that bribery, embezzlement, and procurement corruption remain common in Mexican public service, with the health sector among the most exposed areas. These risks affect not only government institutions but also private providers and suppliers that sell into public systems.

Case studies of Mexico’s social security health institutions (such as IMSS) have documented problems like noncompliance by providers and bid rigging or collusion in pooled medicine purchases, which later led to reforms based on OECD guidelines against collusion. For private clinics, insurers, and vendors that interact with these systems, this context matters. It shapes pricing, service quality, and the integrity of referral and procurement chains.

If you run or work with clinics, pharmacies, or health-related vendors in Mexico, you should expect stricter scrutiny of tenders, referral patterns, and related-party links. You also need clear documentation and conflict-of-interest controls to show that your decisions stand on objective criteria, not on informal agreements.

Travel, Auto, and Insurance Scams Affecting Staff and Clients

Fraud risk is not limited to back-office processes. It also shows up on the road. Recent reports from border and coastal regions describe staged accident schemes in areas such as Baja and Rocky Point, where criminal groups target foreign drivers and try to pressure them into paying large sums after orchestrated collisions or claims of damage.

Other sources aimed at drivers in Mexico warn about common scams at gas stations and on highways, including attempts to manipulate fuel charges or create false incidents to trigger claims. These events create direct financial loss. They also create reputational and legal risk if employees, policyholders, or clients accuse your organization of failing to protect them or respond correctly.

If your teams, insureds, or partners travel by road in Mexico, you should:

• Update travel and fleet policies to include basic fraud awareness for staged accidents and roadside scams.
• Clarify how staff should respond at the scene, who they call first, and how they document events.
• Coordinate with your insurer or TPA on clear procedures for incidents in high-risk areas.

Cross-Border Schemes Using Mexico-Based Operations

Some schemes use Mexico as an operational base while targeting victims in other countries. In 2025, California authorities reported a large workers’ compensation fraud scheme in which a call center based in Mexico allegedly targeted Spanish-speaking workers, pressured them into filing claims under false pretenses, and then sold more than 1,100 client files to attorneys, generating over USD $550,000 in unlawful referral fees.

For insurers, law firms, and corporate employers on both sides of the border, this case is a reminder that:

• Call centers, marketing vendors, and “referral partners” can be a major source of fraud risk if you do not vet them carefully.
• Language and trust are often weaponized. Spanish-speaking workers were targeted because they were less likely to challenge misleading offers.
• Cross-border structures make evidence collection and coordination more complex. You need clear contracts, logs, and audit rights from the start.

What This Means for Your Organization

These examples show that fraud affecting operations tied to Mexico often concentrates in three areas: public procurement and health, travel and auto risk, and cross-border marketing or call-center activity. Fraud control plans that ignore one of these fronts leave a gap that motivated actors can use.

In the next section, we outline how you can take concrete steps during International Fraud Awareness Week to address these risks and how GrayCat PI can support your fraud detection and corporate security efforts in Mexico and across your regional footprint.

How GrayCat PI Can Support Your Fraud Week Plan

International Fraud Awareness Week is a good moment to check where you stand. It is also a good time to bring in external support so you are not reviewing your own work in isolation. At GrayCat PI, we focus on financial crime investigations in Mexico and practical fraud prevention support for insurers, clinics, law firms, and corporate clients.

1. Focused fraud risk mini-reviews

If you only have limited time during Fraud Week, start with a short, focused review. We work with your team to map one or two high-risk processes, such as claims handling, provider payments, procurement, or local intermediaries.

• Clarify who can approve what, and at which levels.
• Identify weak points in documentation, segregation of duties, and oversight.
• Flag specific areas where fraud or collusion is more likely in Mexico.

You can see how we structure this kind of work in our general services overview at https://GrayCatPI.com/private-investigator-in-mexico/.

2. Case reviews and targeted investigations

Many clients reach out because one case, claim, or vendor contract feels wrong. During and after Fraud Week, we can support you with:

• File reviews for suspicious claims, invoices, or medical records.
• Background checks on key individuals and entities involved in a case.
• Asset tracing in Mexico when you suspect diversion of funds or assets, using the methods described in our asset tracing service page at https://GrayCatPI.com/services/asset-tracing-investigation-in-mexico/.

We coordinate with your legal and compliance teams so that evidence collection respects Mexican law and supports your strategy.

3. Practical training and briefings for your teams

Generic training rarely changes behavior. We offer short online or in-person sessions targeted to your role and risk profile. For example:

• For clinics and health providers: red flags in billing and documentation, basic fraud trends in Mexican health claims, and how to escalate a concern safely.
• For insurers: patterns in staged losses, provider fraud, and coordinated claims rings in Mexico.
• For legal and corporate teams: conflicts of interest, third-party risk, and how to preserve digital and physical evidence.

Each session uses real cases from Mexico, with details adjusted to protect confidentiality, and links to external resources such as the ACFE’s Fraud Week materials at https://www.fraudweek.com.

4. Support with policies, hotlines, and response protocols

During Fraud Week, many organizations update their policies but stop there. We help you move from policy to practice by:

• Reviewing your fraud policy and code of conduct for gaps related to Mexico.
• Advising on practical, low-cost reporting channels and how to communicate them.
• Helping you define a clear response protocol for the next suspicion or allegation.

If you want to go deeper, we can help you apply the ACFE Fraud Prevention Check-Up and turn the results into a realistic action plan for the next 6–12 months.

5. Why work with a licensed investigations firm in Mexico

Fraud cases that touch Mexico raise specific legal and practical issues. Working with a licensed firm reduces risk for you and your clients. GrayCat PI is a registered corporation in Mexico and the U.S., with a federal Public Security License (SEP) and SAT registration, as outlined on our main site at https://GrayCatPI.com.

• We understand local procedures, records, and cultural context in Mexico.
• We work within Mexican law so that your evidence and findings are usable in court or internal processes.
• We hold certifications such as CFE, CAMS, CFCS, and ASIS APP, which align with global anti-fraud and security standards.

If your organization wants to use Fraud Week to make concrete progress instead of only sharing messages on social media, we can help plan and execute those next steps with you.

In the next section, we will suggest simple ways to turn this year’s Fraud Week into a clear plan for the next 12 months, including one concrete step you can take this week.

Turn Fraud Week 2025 into a 12-Month Anti-Fraud Plan

Fraud Week should not be a one-time campaign. It can be the start of a clear, simple plan for the next 12 months. Here we suggest how you can move from awareness to action and keep fraud risk on the agenda in Mexico throughout the year.

Set 12-Month Goals Linked to Your Real Risks

Begin by choosing three concrete goals based on what you learned from red flags, mini-reviews, or the ACFE Fraud Prevention Check-Up. Keep them specific and realistic. For example:

• Reduce billing anomalies in Mexican clinic claims by a defined percentage or case count.
• Complete enhanced reviews of your top ten vendors or intermediaries in Mexico.
• Train all managers in Mexico on fraud reporting and conflict-of-interest rules.

Assign one owner for each goal, set a deadline, and agree on how progress will be measured. This keeps your fraud detection services and internal controls focused on the issues that matter most.

Build a Simple Quarterly Review Rhythm

Instead of waiting for the next Fraud Week, schedule short fraud risk reviews every quarter. You can combine them with existing audit, risk, or compliance meetings. In each review, ask:

• Which new red flags, tips, or complaints did we receive in Mexico?
• Which actions from our fraud plan are complete, in progress, or blocked?
• Do we need external support for any case, data review, or policy change?

Keep notes, track decisions, and update your plan. Over time, this routine builds a more mature fraud risk culture without overwhelming your teams.

Connect Controls, Training, and Investigations

Controls, training, and investigations should support each other. When a case or review reveals a weakness, you can:

• Adjust controls or approvals in the affected process.
• Update training materials with anonymized examples from real incidents.
• Review your response protocol so the next case moves faster and with less internal conflict.

This cycle helps you move from one-off reactions to a more stable corporate security framework for your operations in Mexico.

Plan When to Use External Help

Not every fraud concern needs an external investigation. At the same time, some situations carry too much legal or reputational risk to handle alone. It helps to define in advance when you will call a licensed investigations firm such as GrayCat PI. Typical triggers include:

• Allegations that involve senior staff, key providers, or strategic vendors in Mexico.
• Cases where assets, funds, or data may have moved through multiple entities or jurisdictions.
• Situations where you expect possible criminal, regulatory, or civil proceedings.

Clear rules on when to seek external support protect your internal teams and help you respond in a consistent way.

In the next section, we close with a short FAQ and a clear call to action for organizations that want to use International Fraud Awareness Week 2025 as a starting point for stronger fraud controls in Mexico.

FAQ: Fraud Week and Fraud Risk in Mexico

What is International Fraud Awareness Week?

It is a yearly campaign led by the Association of Certified Fraud Examiners that encourages organizations around the world to focus on fraud education, fraud prevention, and early detection. It runs from 16 to 22 November 2025 and includes free resources, events, and toolkits you can use inside your own organization.

Why does Fraud Week matter for organizations with exposure in Mexico?

Because many fraud schemes that touch Mexico involve complex supply chains, health systems, and third-party intermediaries. Fraud Week gives you a clear time window to step back, review controls, and start closing gaps before they turn into major cases. It is especially useful if you manage insurance claims, medical providers, vendors, or cross-border operations.

How can we start if we only have a few hours?

We suggest three steps. First, identify your top three fraud risks in Mexico, such as claims, billing, or procurement. Second, run the ACFE Fraud Prevention Check-Up or a small internal review on one key process. Third, send a clear internal message about how to report concerns, in both English and Spanish. This alone moves you forward.

When should we involve an external investigations firm?

You should consider external support when allegations involve senior people, major providers, or high-value contracts, or when there is a risk of litigation, regulatory action, or media interest. An independent firm with financial crime investigations experience in Mexico can help you gather evidence correctly, protect legal options, and support your internal decision-making.

How can we work with GrayCat PI during or after Fraud Week?

You can contact us through https://GrayCatPI.com to request a short consultation. Together we can decide whether you need a focused fraud risk mini-review, case-specific support, training for your teams, or help applying the ACFE Fraud Prevention Check-Up to your operations in Mexico.

International Fraud Awareness Week 2025 is a good moment to start making fraud risk more visible and more manageable. If you work in insurance, health, law, or corporate operations with exposure in Mexico, what is the one fraud-related action you will commit to this week?

About the Author

Author: Fahad Hizam, Investigator at GrayCat PI

Fahad is a licensed private investigator based in Oaxaca, Mexico. He focuses on financial crime investigations, fraud detection services, and corporate security solutions for insurers, clinics, law firms, and corporate clients with operations or exposure in Mexico. He holds certifications including CAMS, CFCS, and ASIS APP, and is a member of international anti-fraud and security organizations.

Through GrayCat PI, Fahad has supported investigations and fraud risk reviews involving health providers, insurance claims, procurement, and cross-border structures. His work combines field investigation, open-source intelligence, and structured fraud risk assessments in line with ACFE guidance and local legal requirements in Mexico.

If you want to discuss fraud risks in Mexico or how to use International Fraud Awareness Week 2025 inside your organization, you can contact GrayCat PI through https://GrayCatPI.com.

Follow updates under #MexicoFraudWatch.