Type of insurance claim when a claimant intentionally uses false information to obtain medical services or payment for services from his or her insurance company.
Insurance Encyclopedia
Fraudulent claims
Claim where the insured has: (a) made false statements of fact; or (b) made statements, knowing them to be false, or not believing them to be true, or without caring whether they were true or false. Good faith, implied in all insurance contracts, requires that any claim by the insured shall be honestly made. If the insured submits a fraudulent claim all benefit, including the premium, under the policy is forfeited. See CHEATLINE.
***
Dishonest claims made by people who suffered no loss or who magnify a loss for their own gain.
Fraudulent Delivery
In connection with Transportation floaters, when a shipper surrenders goods to someone posing as an agent for the carrier, it is held that the goods did not come into the custody of the carrier. If the carrier delivers goods to someone posting as an agent for the receiver, it is held that no valid delivery is made, and the courier is held liable for the loss.
Fraudulent misrepresentation
UK: Breach of the duty of utmost good faith occurring where the person knowingly makes a false statement relating to a material fact, does not believe it to be true or makes it recklessly without due regard to its accuracy. The Road Traffic Act 1988 makes it a statutory offence for a person to make a false statement or to withhold material information for the purpose of obtaining a certificate of motor insurance required by the Act.
***
MEDICAL,USA: False statement to get an insurance company to provide insurance coverage for an applicant. Fraudulent misrepresentation gives an insurance company grounds to terminate a policy at any time.
***
Misrepresentation made knowingly with intent to deceive, or recklessly without care whether it be true or false.
Fraudulent trading
Occurs when a company continues to trade and incur debts, when, to the knowledge of the director(s), there is no reasonable prospect of the creditors being paid. It includes a situation where there are no good grounds for believing that the company can pay its way even if the director(s) hold an opposite view. Any director guilty of fraudulent trading may be liable to contribute to the company’s assets. See DIRECTORS’ AND OFFICERS’ LIABILITY.
Fraudulent withdrawals and forged signatures insurance
A policy to indemnify building societies and similar institutions against losses incurred as a result of payments made in connection with fraudulent withdrawals and forged signatures. The annual premium is adjustable and is based on the annual amount of withdrawals.
Free alongside Ship (FAS)
Quoted price includes the cost of delivering the goods alongside a designated vessel.
Free Asset
An asset of an insurance company that is not earmarked for the fulfillment of a limited class of obligations such as satisfying claims in one section of its business only.
Free asset ratio
For UK life insurance companies only, a solvency measure calculated as available assets minus the required minimum margin/admissible assets. All other things equal, the higher the free asset ratio, the higher the level of surplus capital relative to the asset base. Reported free assets ratio are dependent on the assumptions made to value the liabilities.
Free assets
Life insurance company’s assets that exceed the sum of the company’s liabilities and the required minimum margin of solvency (RMM). It is a measure of surplus capital once the RMM has been covered.