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12 Cards in this Set
- Front
- Back
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Workers compensation schemes are generally broken into four categories. Which of the following is not one of these categories? A. Agent Fraud B. Premium Fraud C. Claimant Fraud D. Doable duty fraud |
Doable duty fraud |
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Which of the following is the best definition of the automobile insurance scheme known as ditching? A. An agent inflates his commissions by pressuring customer to unnecessarily replace existing policies for new ones. B.An insured falsely reports a vehicle is stolen to collect on an insurance policy. C. An insured has two insurance policies in place and files claims with both. D. An agent selects a customer's premium, but does not remit the payment to the insurance company. |
An insured falsely reports a vehicle is stolen to collect on an insurance policy |
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_____ is the term used for including additional coverages in an insurance policy without the insured's knowledge. |
Sliding |
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Which of the following is true concerning the different types of workers compensation fraud schemes? A. In premium fraud, an employer might understate the amount the payroll for higher risk classifications to get a lower-cost premium. B. In an organized fraud scheme, a lawyer, a Capper, a doctor, in the claimant off include to defraud the insurance company. C. In an agent fraud scheme, agents sometimes issues certificates of coverage to the insured customer wall pilfering the premium. D. All of these answers are correct. |
All of these answers are correct |
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Elizabeth, a grocery store cashier, slips on a wet floor and Falls while at work. She is unharmed, but she pretends to suffer an injury from the fall. She files a claim against the storer's workers compensation insurance policy, and she collects payments from the insurance carrier. She also misses several weeks of work, even though she is fully capable of working. Under which category of workers compensation schemes does Elizabeth's scheme fall? |
Claimant fraud |
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The restitution against lost to a third-party when the insured fails to fulfill a specific undertaking for the third parties benefit is referred to as: |
An Indemnity Bond |
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Jan, a certified fraud examiner for a major insurance company, has received an anonymous tip that an employee in the claims department is processing claims for his own benefit during non-working hours. To gather information about the validity of this tip, Jan should look at which of the following reports? A. Address similarity report B. Manual override report C. Exception report D. All of these answers are correct |
All of these answers are correct |
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Insurance agent/ broker fraud includes which of the following? A. Fictitious payees B. Fictitious death claims C. premium theft D. All of these answers are correct |
All of these answers are correct |
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Jeremy is involved in an automobile accident but does not have insurance. To be reimbursed for the damages, he gets Insurance, wait a short time, and then reports the vehicle as having been in an accident. He has committed an insurance scam known as.... |
Past posting |
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A tombstone policy is.... |
A fictitious insurance policy |
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All of the following are red flags of fraudulent insurance claims except: A. A claim is made a short time after the policies Inception B. A fire loss claim does not include family heirlooms or other sentimental items C. The insured does not have a history of making insurance claims D. A theft claim includes a lot of recently purchased expensive property |
The insured does not have a history of making insurance claims |
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The largest amount of insurance fraud occurs in the area of... |
Healthcare |
