Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed.

-Failure to make required refunds when services are not reasonable and necessary.

Question

Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed.

-Failure to make required refunds when services are not reasonable and necessary.

Quizplus · Accepted Answer

This is a case of insurance abuse, as the insurer is not fulfilling their specified obligations to refund for services that are deemed unreasonable or unnecessary. Fraud would be applicable if the insurer intentionally and knowingly withheld these refunds for their own financial gain.

Determine Whether the Following Statements Are Cases of Insurance (A)