False Insurance Claims Law and Legal Definition

False insurance claims is a type of defrauding activity committed with the intention to defraud an insurance provider. The act of false insurance claim is committed to fraudulently obtain a payment from an insurer.

The main motive with which the false insurance claim is committed is to attain financial profit. False insurance claims is commonly known as insurance fraud.

The following is an example of a state statute (Washington) defining insurance fraud:

Rev. Code Wash. (ARCW) § 48.135.010 define insurance fraud as: (1) "Insurance fraud" means an act or omission committed by a person who, knowingly, and with intent to defraud, commits, or conceals any material information concerning, one or more of the following:

(a) Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, insurance producer, or surplus line broker, false information as part of, in support of, or concerning a fact material to one or more of the following:

(i) An application for the issuance or renewal of an insurance policy;

(ii) The rating of an insurance policy or contract;

(iii) A claim for payment or benefit pursuant to an insurance policy;

(iv) Premiums paid on an insurance policy;

(v) Payments made in accordance with the terms of an insurance policy; or

(vi) The reinstatement of an insurance policy;

(b) Willful embezzlement, abstracting, purloining, or conversion of moneys, funds, premiums, credits, or other property of an insurer or person engaged in the business of insurance; or

(c) Attempting to commit, aiding or abetting in the commission of, or conspiracy to commit the acts or omissions specified in this subsection.