Common use of Fraud Management Clause in Contracts

Fraud Management. EHCP hereby agrees that under the AB PM-▇▇▇ fraud shall be defined as any intentional deception, manipulation of facts and / or documents or misrepresentation made by the EHCP or by any person or organization appointed employed / contracted by the EHCP with the knowledge that the deception could result in unauthorized financial or other benefit to herself/himself or some other person or the organisation itself. It includes any act that may constitute fraud under any applicable law in India. Pursuant to any trigger alert related to possible fraud at the level of the EHCP, the SHA or its authorised representatives shall have the liberty to undertake investigation of the case. The SHA shall on an ongoing basis measure the effectiveness of anti-fraud measures in the AB PM-▇▇▇ through a set of indicators. For a list of such indicative (not exhaustive) indicators, refer to Annex 8. In the event that the EHCP or any of its employee or consultant or contractor undertakes any fraudulent activity and if the fraud is proven through investigation, the SHA shall: refuse to honour a fraudulent Claim or Claim arising out of fraudulent activity or reclaim all benefits paid in respect of a fraudulent claim or any fraudulent activity relating to a claim from the EHCP; and/or de-empanel or delist the EHCP, with the procedure specified in Annex 6; and/or terminate this services agreement with the EHCP and if deemed appropriate initiate civil and / or criminal proceedings as per Applicable Laws. For fraudulent activities by any of its employee or consultant or contractor, the vicarious liability shall vest with the EHCP and the EHCP shall be obliged to initiate action against such employee or consultant or contractor as per the directions of the SHA which may include but not be limited to (a) disciplinary actions; and / or (b) termination of services / contract; and / or (c) debarring engagement / employment with another provider under AB PM-▇▇▇; and / or (d) civil and / or criminal proceedings as per Applicable Laws.

Fraud Management. 1. EHCP hereby agrees that under the AB PM-▇▇▇ fraud shall be defined as any intentional deception, manipulation of facts and / or documents or misrepresentation made by the EHCP or by any person or organization appointed employed / contracted by the EHCP with the knowledge that the deception could result in unauthorized financial or other benefit to herself/himself or some other person or the organisation itself. It includes any act that may constitute fraud under any applicable law in India. 2. Pursuant to any trigger alert related to possible fraud at the level of the EHCP, the SHA or its authorised representatives shall have the liberty to undertake investigation of the case. 3. The SHA shall on an ongoing basis measure the effectiveness of anti-fraud measures in the AB PM-PM- ▇▇▇ through a set of indicators. For a list of such indicative (not exhaustive) indicators, refer to Annex 8. 4. In the event that the EHCP or any of its employee or consultant or contractor undertakes any fraudulent activity and if the fraud is proven through investigation, the SHA shall: : i. refuse to honour a fraudulent Claim or Claim arising out of fraudulent activity or reclaim all benefits paid in respect of a fraudulent claim or any fraudulent activity relating to a claim from the EHCP; and/or and/or ii. de-empanel or delist the EHCP, with the procedure specified in Annex 6; and/or and/or iii. terminate this services agreement with the EHCP and if deemed appropriate initiate civil and / or criminal proceedings as per Applicable Laws. 5. For fraudulent activities by any of its employee or consultant or contractor, the vicarious liability shall vest with the EHCP and the EHCP shall be obliged to initiate action against such employee or consultant or contractor as per the directions of the SHA which may include but not be limited to (a) disciplinary actions; and / or (b) termination of services / contract; and / or (c) debarring engagement / employment with another provider under AB PM-▇▇▇; and / or (d) civil and / or criminal proceedings as per Applicable Laws.