Types of Fraud

Insurance fraud is deliberate deception perpetrated against or by an insurance company or agent for the purpose of financial gain. Fraud may be committed at different points by applicants, policy holders, third-party claimants, or professionals who provide services to claimants. Such claim fraudulent acts are at a rise at an alarming role which results in high losses to the insurance company.

The insurance company unable to handle too many frauds which could be the cause of huge financial loss. To find the information about a fraud person who is claiming insurance. The company need to take actions against the fake claimers who may destroy the complete business of the company. Huge rise of such situation, have clearly specified the role of claim investigators who found effective in providing professional and insurance investigation services to the clients to eradicate the frauds in insurance sector .

Fraud and abuse take place at many points in the healthcare system. Doctors, hospitals, nursing homes, diagnostic
facilities, medical equipment suppliers and attorneys have been cited in scams to defraud the system. 
The most prevalent types of healthcare fraud are:

• Billing for services not rendered.
• Inflated billing for services and medical items (the provider submits an inflated bill that yields a higher payment than for the  service or item that was actually rendered).
• Filing duplicate claims.
• Unbundling (billing in a fragmented fashion for tests or procedures that are required to be billed together at reduced cost).
• Performing excessive services performing unnecessary services; and offering kickbacks.
  
• Another common type of fraud is the abuse and resale of legal narcotic and other prescription drugs.
  
• Health identity theft is when criminals steal victims’ names, health insurance numbers and other personal data and then defraud
  insurers by making false claims.
  
• One of the most common forms of insurance fraud is the exaggeration of injuries sustained in an accident.