there have been insurance claim frauds. Considering the nature & existing scope of the process to raise & settle insurance claims, it is practically impossible to eliminate leakages and frauds cannot entirely. However, with robust scrutiny, structured process, and checks and balances, frauds can be detected, controlled, and kept within a limit.

A fraudulent Health Insurance claim is an Insurance claim prepared with the intention to conceal or manipulate relevant information with an intention to deceive or mislead a health insurance provider in an attempt to seek irrational, exorbitant, and unauthorized benefits for the policyholder, healthcare provider, or intermediaries involved in selling, managing or settling insurance claims.

It is a major morale and a moral hazard, not only for the Insurance Industry but even for the entire nation’s economy