Definitions for "Insurance Fraud"
Intentional misrepresentation of the facts in order to obtain reimbursement from an insurer.
1) Intentional lying or concealment by policyholders to obtain payment of an insurance claim that would otherwise not be paid. 2) Lying or misrepresentation by insurance company managers, employees, agents and brokers for their personal enrichment.
A fraudulent insurance act is committed by any person who, knowingly and with intent to defraud, presents causes to be presented or prepares with knowledge or belief that it will be presented to or by an insurer or purported insurer, or any agent thereof, any written statement as part of, or in support of, an application for the issuance of, or the rating of an insurance policy for commercial insurance, or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which he knows to: (i) contain materially false information concerning any fact material thereto; or (ii) conceal, for the purpose of misleading, information concerning any fact material thereto.
Any fraud that involves an insurance company, whether committed by consumers, insurance company employees, agents, health care providers, or anyone else connected with an insurance transaction.