#1
What is insurance fraud?
An intentional deception or misrepresentation made by an individual or entity to obtain money from an insurance company
ExplanationDeceptive actions to gain money from insurers.
#2
In insurance terminology, what does the acronym 'ACV' stand for?
Actual Cash Value
ExplanationThe real market value of insured property.
#3
In insurance, what does the term 'deductible' refer to?
The amount an insured person pays out of pocket before the insurance coverage kicks in
ExplanationInitial out-of-pocket amount before insurance coverage starts.
#4
Which of the following is a common type of insurance fraud?
Staged accidents
ExplanationPlanned incidents to fake insurance claims.
#5
What is redlining in the context of insurance fraud?
A discriminatory practice where insurers refuse coverage or charge more based on characteristics associated with a particular area
ExplanationDiscriminatory denial or pricing based on location.
#6
What is the 'exclusion' clause in insurance policies?
A clause that excludes coverage for specific risks or conditions mentioned in the policy
ExplanationPolicy provision excluding coverage for specified risks or conditions.
#7
What is 'subrogation' in the context of insurance?
The legal right of an insurer to pursue a third party that caused a loss to the insured
ExplanationInsurer's right to go after responsible third parties.
#8
What is 'fronting' in the context of insurance?
A type of insurance fraud involving fake policies
ExplanationFraudulent creation of false insurance policies.
#9
What is 'underwriting' in the insurance industry?
The process of evaluating the risk and deciding whether to provide coverage
ExplanationRisk assessment and decision-making in offering coverage.
#10
What is 'co-insurance' in the context of health insurance?
A cost-sharing arrangement between the insured and the insurer after the deductible is met
ExplanationShared costs between insured and insurer after meeting deductible.
#11
What is 'claims adjuster' responsible for in the insurance industry?
Assessing and determining the amount of compensation for a covered loss
ExplanationEvaluating and determining compensation for covered losses.
#12
What is the purpose of an 'insurance binder'?
A document that temporarily provides evidence of insurance coverage until a formal policy is issued
ExplanationTemporary evidence of insurance coverage.
#13
What is 'insurable interest' in insurance contracts?
The financial interest an insured person has in the property or person being insured
ExplanationFinancial interest in the insured property or person.
#14
What is 'policyholder surplus' in the insurance industry?
The amount of money an insurer has leftover after paying claims and expenses
ExplanationRemaining funds after covering claims and expenses.
#15
What role do insurance investigators play in combating fraud?
Investigating suspicious claims and identifying fraudulent activities
ExplanationProbing claims to uncover fraud and identify wrongdoing.
#16
What are some preventive measures insurance companies can take to combat fraud?
Implementing fraud detection technology
ExplanationUsing technology to prevent and detect fraudulent activities.
#17
What is a 'moral hazard' in the context of insurance?
A situation where the insured intentionally creates or worsens a loss
ExplanationIntentional actions by the insured leading to losses.
#18
What is 'coinsurance' in insurance policies?
A clause that allows the insured to share the cost of covered services with the insurer
ExplanationShared cost arrangement between insured and insurer.
#19
What is 'rescission' in the context of insurance contracts?
The cancellation of an insurance policy retroactively
ExplanationRetroactive cancellation of insurance policies.
#20
What is 'reinsurance' in the insurance industry?
Insurance purchased by insurance companies to limit their risk exposure
ExplanationInsurance for insurers to manage risk exposure.
#21
What is the role of the National Insurance Crime Bureau (NICB) in the United States?
To combat insurance fraud and vehicle theft
ExplanationFighting insurance fraud and vehicle theft in the U.S.
#22
What is 'reverse rate evasion' in insurance terminology?
A situation where an insured intentionally misrepresents their true location to obtain lower rates
ExplanationInsured misrepresentation for lower insurance rates.
#23
What is 'insurance underwriting'?
The process of evaluating and classifying the risk of insuring a particular person or asset
ExplanationAssessment and classification of the risk for insurance.
#24
What is 'anti-selection' in insurance?
A situation where higher-risk individuals are more likely to purchase insurance
ExplanationHigher-risk individuals being more inclined to buy insurance.
#25
What is the 'incontestability clause' in life insurance policies?
A clause stating that the insurance company cannot contest the validity of the policy after a certain period
ExplanationPreventing insurance companies from contesting policy validity after a specific period.