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Health Insurance Fraud Essay

4446 words - 18 pages

Health Insurance Fraud

By:
WAHEED ALKHAMEES
KHALED ALNAFEE

Further Issues Hospital Administration
PA 551

Master of Health and Hospital Administration (Parallel)
King Saud University

One:- Introduction
Definition
Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for
payment. It is a form of risk management primarily used to hedge against the risk of a
contingent, uncertain loss.
An insurer, or insurance carrier, is a company selling the insurance; the insured, or policyholder,
is the person or entity buying the insurance policy. The amount of money to be charged for a
certain amount of insurance coverage is called the ...view middle of the document...

There are two major types of
health insurance. Social and private insurance. Most of the countries have one implemented type
among citizens or a mixture of both types.

Accident, sickness, and unemployment insurance

Disability insurance policies provide financial support in the event of the policyholder becoming
unable to work because of disabling illness or injury. It provides monthly support to help pay
such obligations as mortgage loans and credit cards. Total permanent disability insurance

provides benefits when a person is permanently disabled and can no longer work in their
profession, often taken as an adjunct to life insurance.

Casualty insurance

Casualty insurance insures against accidents, not necessarily tied to any specific property. It is a
broad spectrum of insurance that a number of other types of insurance could be classified, such
as auto, workers compensation, and some liability insurances.

Life insurance

Life insurance provides a monetary benefit to a decedent's family or other designated
beneficiary, and may specifically provide for income to an insured person's family, burial,
funeral and other final expenses. Life insurance policies often allow the option of having the
proceeds paid to the beneficiary either in a lump sum cash payment or an annuity. In most states,
a person cannot purchase a policy on another person without their knowledge.

Burial insurance

Burial insurance is a very old type of life insurance which is paid out upon death to cover final
expenses, such as the cost of a funeral.

Property insurance

Property insurance provides protection against risks to property, such as fire, theft or weather
damage. This may include specialized forms of insurance such as fire insurance, flood insurance,
earthquake insurance, home insurance, inland marine insurance or boiler insurance.

Liability insurance

Liability insurance is a very broad superset that covers legal claims against the insured. The
protection offered by a liability insurance policy is twofold: a legal defense in the event of a
lawsuit commenced against the policyholder and indemnification (payment on behalf of the
insured) with respect to a settlement or court verdict.

Credit insurance

Credit insurance repays some or all of a loan when certain circumstances arise to the borrower
such as unemployment, disability, or death.

Other types

There are many other types such as Business interruption insurance, Collateral protection
insurance, Livestock insurance and others.

Tow:- Insurance Fraud
Insurance Fraud
Insurance fraud occurs when any act is committed with the intent to fraudulently obtain some
benefit or advantage to which they are not otherwise entitled or someone knowingly denies some
benefit that is due and to which someone is entitled.
Insurance fraud has existed ever since the beginning of insurance as a commercial enterprise.
Fraudulent activities also...

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