MEDICAL INSURANCE FRAUDS – CONSEQUENCES AND METHODS OF FIGHTING AGAINST THEM

Iulia CAPRIAN, Marcela ENACHE Universitatea de Stat din Moldova

Abstract

Over the course of a year, there are millions of health insurance claims submitted to the healthcare companies that help make quality care more affordable. Out of these millions of claims, a small percentage are fraudulent, but that small percentage supposes cost a estimated to a sum of tens of billions of dollars annually, leading to higher premiums and other out-of-pocket expenses. Out of all the types of insurance frauds, the medical insurance fraud makes up the majority of false claims, revealing why this is such an important problem. In this case, it is very important for companies to know how to manage these kind of situations and for consumers how to protect themselves. Keywords: medical insurance, fraud, insurer, medical services, fraud management.