Insurance Fraud

Amulya S, 25FRSA60; Manuja, 25FRSA29; Grace Evangeline S, 25FRSA58, BSc II Sem A, Department of Forensic Science, Kristu Jayanti University, Bengaluru, India

Insurance fraud refers to any intentional act of deception committed by an individual or an insurance company to obtain benefits to which they are not legally entitled or to deny legitimate claims. It may occur during policy application, premium payment, or claim settlement. Common forms include filing false or exaggerated claims, misrepresentation of risk, premium diversion, asset diversion, and workers’ compensation fraud.

Insurance fraud causes substantial financial losses worldwide, costing billions of dollars annually and leading to higher insurance premiums for honest policyholders. Studies indicate that fraud occurs across health, property, unemployment, and casualty insurance sectors. In some cases, insurers themselves may engage in unethical practices such as wrongful denial or cancellation of valid claims.

The primary motive behind insurance fraud is financial gain, often driven by greed and weak fraud-detection mechanisms. Because many fraudulent activities go undetected, the actual cost to society is difficult to estimate.

Insurance fraud is a serious economic offence that undermines trust in the insurance system, increases costs for consumers, and places a burden on regulatory and law enforcement agencies. Preventing it requires vigorous legal enforcement, effective fraud detection systems, and increased public awareness.

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