Professional organization that provides social and insurance benefits to its members.

MEDICAL,USA: 1. An intentional misrepresentation of the facts to deceive or mislead another. 2. In a health care setting, the intentional deception or misrepresentation that an individual knows, or should know, to be false, or does not believe to be true, and makes, knowing the deception could result in some unauthorized benefit to himself or some other person(s). In addition, fraud may be committed by either providers or patients to obtain services, payment for services, or claim program eligibility. 3. In insurance claims, some fraudulent practices are intentionally double billing for the same services, reporting diagnoses and procedures to maximize payments, billing for services that were not performed, altering claim forms for higher reimbursement, soliciting or receiving kickbacks or bribes, using another person’s Medicare card, and falsely representing services provided. 4. Lying or intentional misrepresentation by insurance company managers, employees, agents, or brokers for their own gain.
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Obtaining an advantage by unfair or wrongful mans. Deception or artifice used to deceive or cheat.
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The intentional perversion of the truth in order to mislead someone into parting with something of value. Black’s Law Dictionary, 6th Edition, defines “fraud” as an intentional perversion of the truth for the purpose of inducing another in reliance upon it to part with some valuable thing belonging to him or to surrender a legal right a false representation of a matter of fact, whether by words or by conduct, by false or misleading allegations or by concealment of that which should have been disclosed, which deceives and is intended to deceive another so that he shall act upon it to his legal injury.

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 provision that allows the insured to choose any licensed health care provider for medical services.

Specific amount of time after delivery of an insurance policy by the agent during which the policy owner may look the policy over and return it to the insurance company for a complete refund of the first premium payment. Usually, complete insurance coverage is provided during this time period. Also called 10-day free look .

Section of tissue is detached from its base but its arterial and venous components are reattached. CPT codes include 15756 to 15758.

Period of time, usually 30 days, when an individual can try out a Medigap policy. During that time, if the individual changes his or her mind about keeping the policy, it can be cancelled and any money paid is refunded.
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A period of time (usually 10, 20 or 30 days) during which a policyholder may examine a newly issued individual policy of life or health insurance, and surrender it in exchange for a full refund of premium if not satisfied for any reason.