Definition of wrongdoing is any fraud, corruption, collusion, coercion, illegal conduct, misconduct, financial mismanagement, accounting irregularities, conflict of interest, wrongful conduct, irregular, unethical or other practices. From violations of applicable regulations and instructions or covering up any of the above.
Insurance fraud is defined as any intentional act by one of the parties to the insurance process with the aim of obtaining impermissible or legitimate compensation or benefits for the fraudster or others.
Fraud may take any of the following forms:
Effect of fraud on healthcare insurance industry:
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