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Economic law related (you can decide) - Research Paper Example

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What is Insurance Fraud, and Why is it Difficult to Detect? The crime of insurance fraud has been a major issue for many states, and the federal government for some time. When the crime of insurance fraud occurs it is most often undetected. Many types of insurance fraud cases are difficult to detect…
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Economic law related (you can decide)
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Download file to see previous pages When someone is involved in insurance fraud, the insurance company has to pay for the claim. When the insurance company pays for a claim that was inflated the other customers of the insurance company have to pay higher premiums because the insurance company needs to cover its own losses. “Consumer dishonesty stems from a complex interplay of motivations and circumstances, moderated by morality, opportunity, social norms, and institutional context,” Tennyson (1181). There are many types of insurance fraud. Medicare, and Medicaid insurance claims are the most often abused forms of insurance fraud. Doctors can abuse Medicare, and Medicaid insurance claims in many ways. Doctors’ bill for services the doctor never administered to the patient, such services include seeing a patient for 10 minutes, and billing Medicaid, or Medicare for a 30 minute visit. “False claim schemes are the most common type of health insurance fraud,” Barrett (1). Insurance fraud “is any action taken by an individual with the intent to fraudulently obtain payment from an insurer,” Division of Insurance Fraud (1). There are many phoney insurance companies that will collect payments from consumers and these companies do not pay the claims made by consumers when the consumer goes to the doctor. This is one of the fastest growing insurance frauds today. This type of insurance fraud costs consumers millions of dollars per year. ...
Many insurance companies who suspect there may be a case of fraud will allow the case to go through. These insurance companies will pay some claims, even if these claims look suspicious. “These companies believe it is cheaper to pay some smaller suspect claims than fight in court, and a quick payoff may also avoid multimillion dollar lawsuits for bad faith,” Consumer Information (1). Insurance fraud can be classified as a hard crime, or a soft crime. Insurance fraud that is considered hard crime is a crime that was staged. Such crimes include a staged car accident. A soft insurance fraud case is a consumer inflating the price of a real insurance claim. A soft insurance crime is one that is often difficult to detect. Penalties for insurance fraud vary from state to state. The federal government also has different regulations for prosecuting, and punishing those involved in insurance fraud. Insurance fraud is one of the most widely abused crimes in the United States today. Many abuse the insurance company and make fraudulent claims against an insurance policy just because it is almost impossible to detect insurance fraud. “Insurance fraud often goes completely undetected, whether because the values are too small to really attract the attention of any fraud-seeking systems, or whether it is because the insurance companies decide it is not worth it to pursue an investigation of fraud for this particular fraudulent claim,” Insurance Fraud Penalties (1). Every state, and the federal governments have rules, and regulations involving the insurance industry. Many of these rules, and regulations are for anyone who suspects that someone is trying to fraud the insurance company the person should let the ...Download file to see next pagesRead More
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