Unfair Claims Practice

Definition

  • When an insurer unfairly, and sometime fraudulently, tries to avoid or reduce legitimate insurance claims.

Synonyms
bad faith insurance, fraudulent claims practice, insurance fraud

Related Terms and Acronyms

  • Claims Adjuster Definition,
    • An individual who ascertains the insurer's liability after an insurance claim has been made.
  • Clean Sheeting Definition,
    • A type of insurance fraud where an individual deliberately fails to disclose a pre-existing condition in order to receive coverage, sometimes with the help of an insurance broker.
  • Collusion Definition,
    • A secret, deceitful agreement by two or more parties to defraud others.
  • Fake Claim Definition,
    • An insurance claim made fraudulently.
  • Impaired Insurer Definition,
    • An insurance company that is financially insolvent or illiquid and in risk of being unable to pay insurance claims.
  • Insurance Claim Definition,
    • An application for benefits made by an insurance policyholder after an insured event.
  • Insurance Fraud Definition,
    • An illegal attempt by an individual or entity to receive insurance benefits that they would otherwise not be entitled to or for an insurance company to deny a legitimate insurance claim.
  • Insurance Policy Definition,
    • A legal contract between an insurer and entity that specifies what the insurer is required to cover and any benefits the insured entity is entitled to.
  • Loss Adjustment Expenses (LAE) Acronym,
    • Expenses incurred by loss adjusters when they investigate and settle claims.
  • Mis-selling Definition,
    • The act of misleading a client into buying a product or service by deliberately misrepresenting the aforementioned product or service.
  • Unauthorized Insurance Definition,
    • A fraud where a scammer sells a victim an insurance policy that doesn't exist.
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