How is "insurance fraud" defined?

Insurance fraud is defined as any act committed with the intent to defraud the insurance process. This means that the individual engaging in the fraudulent activity does so with a deliberate purpose to deceive the insurance company, aiming to gain benefits or money that they are not entitled to. This can include behaviors such as submitting false claims, exaggerating the extent of a loss, or providing misleading information during the application process.

In contrast, the other options describe situations that lack the intent to deceive. For example, an honest mistake is simply an error without malicious intent, while a miscommunication between the insurer and the insured does not involve deceit but rather misunderstanding. Lastly, a legitimate claim that is mistakenly flagged as fraudulent also does not involve fraudulent intent, as the claim is valid but incorrectly categorized. Hence, defining insurance fraud revolves around the clear intention to deceive and commit an unlawful act against the insurance system.