Document fraud
Document fraud is the use of falsified, altered, duplicated, or misrepresented documents to obtain payment or other financial benefit. In insurance, it often involves receipts, invoices, medical bills, or supporting evidence attached to claims.
Key takeaways
- Includes fabrication, alteration, and duplicate submission.
- Distinct from honest clerical errors—context and review matter.
Examples
- Inflated repair invoices
- Duplicate pharmacy receipts
- Synthetic proof-of-purchase
- Wrong document type for a claimed expense
Why it matters for insurers
Document fraud inflates loss costs and erodes trust in straight-through processing. Detection programs aim to flag indicators early while preserving fair treatment of genuine claimants.