WebCE Insurance Fraud Exam with all Correct & 100%
Verified Answers |Actual Complete Update |Already
Graded A+
______ is suitably described as theft by deception. ✔Correct Answer-Fraud
______ insurance fraud takes place when a person deliberately fakes an accident or fabricates a
loss ✔Correct Answer-Hard
_____ insurance fraud occurs when someone pads or adds to a legitimate claim, it can also be
as opportunistic fraud. ✔Correct Answer-Soft
_______ fraud is committed against an insurance company or its policyholders by insurance
agents, managers, executives, and other employyees ✔Correct Answer-Internal
___________ on insurance applications take place when agents assist applicants in
misrepresenting or omitting information material to the coverage sought ✔Correct Answer-
Misrepresentations
If misrepresentation is not discovered until after a loss, the company may rescind the policy and
___________________ ✔Correct Answer-deny the claim.
________ Fraud schemes are those directed against insurance companies by individuals or
entities such as policyholders, medical providers, beneficiaries, and career criminals. (arson,
disaster fraud, maufactured fraudulent claims, exaggerated claims) ✔Correct Answer-External
________ fraud involves claims made by disaster victims for more damages than actually
occurred or damages that never occurred. It can also include collecting money to repair
damaged property but not completing the work ✔Correct Answer-Disaster
Manufacturing a _____________ claim may involve a staged auto accident, burglary, vandalism,
or mugging; ✔Correct Answer-fradulent
__________ a claim is essentially overstating the amount of loss on an otherwise legitimate
claim. ✔Correct Answer-Exaggerating
When a medical provider inflates the amount billed for medical services or procedures, this is
called __________ ✔Correct Answer-upcoding
________ is when insurance contracts provide both the insured and insurer with opportunities
for misuse of insurance. ✔Correct Answer-Overinsurance
, A _______ hazard exists because the insured may be tempted to make a false or exaggerated
claim to profit from the loss ✔Correct Answer-moral
_________ mills, or medical mills, are organized fraud rings involving medical practitioners and
lawyers. These rings make a practice of recruiting claimants to file phony insurance claims, often
for workers' compensation injuries. ✔Correct Answer-Claim
________________ facts to claim prior damage or injury differs from manufacturing a
fraudulent claim. ✔Correct Answer-Misrepresenting
Manufacturing a claim is ______ fraud, while misrepresenting the facts of an otherwise legal
claim is ________ fraud ✔Correct Answer-Hard/Soft
______ posting occurs when a person is involved in an auto accident or is a victim of a car theft
or other loss but does not have insurance coverage. ✔Correct Answer-Past
___________ occurs when an agent or insurance representative affixes a past date on an
insurance application, or falsifies the date on which a premium payment is recieved.
✔Correct Answer-Backdating
________ Injury schemes involve staged slips, falls, and other contrived events. ✔Correct
Answer-Bodily
_____ is brought about by a perceived financial need; motivates a person to commit a crime of
fraud. ✔Correct Answer-Pressure
__________ is represented by a situation that enables fraud to take place; offer a method by
which fraud can be committed ✔Correct Answer-Opportunity
_____________ occurs because most fraudsters see themselves as ordinary people who got
caught up in a bad set of circumstances. ✔Correct Answer-Rationalization
A person who pads or adds to a legitimate claim commits which type of insurance fraud?
✔Correct Answer-soft fraud
Claim mills are organized fraud rings involving:
a. unscrupulous insurance agents
b. dishonest claims handlers
c. medical practitioners and lawyers
d. insurance consumers ✔Correct Answer-c. medical practitioners and lawyers
What term is used to describe a deliberately faked claim or accident?
a. misrepresentation
Verified Answers |Actual Complete Update |Already
Graded A+
______ is suitably described as theft by deception. ✔Correct Answer-Fraud
______ insurance fraud takes place when a person deliberately fakes an accident or fabricates a
loss ✔Correct Answer-Hard
_____ insurance fraud occurs when someone pads or adds to a legitimate claim, it can also be
as opportunistic fraud. ✔Correct Answer-Soft
_______ fraud is committed against an insurance company or its policyholders by insurance
agents, managers, executives, and other employyees ✔Correct Answer-Internal
___________ on insurance applications take place when agents assist applicants in
misrepresenting or omitting information material to the coverage sought ✔Correct Answer-
Misrepresentations
If misrepresentation is not discovered until after a loss, the company may rescind the policy and
___________________ ✔Correct Answer-deny the claim.
________ Fraud schemes are those directed against insurance companies by individuals or
entities such as policyholders, medical providers, beneficiaries, and career criminals. (arson,
disaster fraud, maufactured fraudulent claims, exaggerated claims) ✔Correct Answer-External
________ fraud involves claims made by disaster victims for more damages than actually
occurred or damages that never occurred. It can also include collecting money to repair
damaged property but not completing the work ✔Correct Answer-Disaster
Manufacturing a _____________ claim may involve a staged auto accident, burglary, vandalism,
or mugging; ✔Correct Answer-fradulent
__________ a claim is essentially overstating the amount of loss on an otherwise legitimate
claim. ✔Correct Answer-Exaggerating
When a medical provider inflates the amount billed for medical services or procedures, this is
called __________ ✔Correct Answer-upcoding
________ is when insurance contracts provide both the insured and insurer with opportunities
for misuse of insurance. ✔Correct Answer-Overinsurance
, A _______ hazard exists because the insured may be tempted to make a false or exaggerated
claim to profit from the loss ✔Correct Answer-moral
_________ mills, or medical mills, are organized fraud rings involving medical practitioners and
lawyers. These rings make a practice of recruiting claimants to file phony insurance claims, often
for workers' compensation injuries. ✔Correct Answer-Claim
________________ facts to claim prior damage or injury differs from manufacturing a
fraudulent claim. ✔Correct Answer-Misrepresenting
Manufacturing a claim is ______ fraud, while misrepresenting the facts of an otherwise legal
claim is ________ fraud ✔Correct Answer-Hard/Soft
______ posting occurs when a person is involved in an auto accident or is a victim of a car theft
or other loss but does not have insurance coverage. ✔Correct Answer-Past
___________ occurs when an agent or insurance representative affixes a past date on an
insurance application, or falsifies the date on which a premium payment is recieved.
✔Correct Answer-Backdating
________ Injury schemes involve staged slips, falls, and other contrived events. ✔Correct
Answer-Bodily
_____ is brought about by a perceived financial need; motivates a person to commit a crime of
fraud. ✔Correct Answer-Pressure
__________ is represented by a situation that enables fraud to take place; offer a method by
which fraud can be committed ✔Correct Answer-Opportunity
_____________ occurs because most fraudsters see themselves as ordinary people who got
caught up in a bad set of circumstances. ✔Correct Answer-Rationalization
A person who pads or adds to a legitimate claim commits which type of insurance fraud?
✔Correct Answer-soft fraud
Claim mills are organized fraud rings involving:
a. unscrupulous insurance agents
b. dishonest claims handlers
c. medical practitioners and lawyers
d. insurance consumers ✔Correct Answer-c. medical practitioners and lawyers
What term is used to describe a deliberately faked claim or accident?
a. misrepresentation
