Define "insurance fraud."

Study for the Certified Insurance Counselor Commercial Multiline Exam. Utilize interactive flashcards and multiple-choice questions, all with detailed explanations. Prepare thoroughly for your exam!

Insurance fraud refers specifically to deliberate deception or misrepresentation intended to secure an unfair or unlawful financial gain from an insurance policy. This includes actions where an individual knowingly provides false information, fabricates a claim, or otherwise deceives the insurer to receive a benefit they are not entitled to.

It is crucial to differentiate this from unintentional mistakes or errors. Unintentional mistakes made while filing a claim or errors in claims processing by the insurance company are not considered fraud since they do not involve intent to deceive. Similarly, fraudulent claims submitted without any malicious intent would not meet the legal definition of fraud, as there would be no deliberate deception involved. Thus, the definition provided in the correct answer encapsulates the core concept of insurance fraud, aligning with legal interpretations and insurance policies.

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