What is insurance fraud in the context of casualty insurance?

Insurance fraud in the context of casualty insurance involves intentionally misleading an insurer to gain benefits that one would not otherwise be entitled to receive. This can include various deceptive practices, such as providing false information about the circumstances of a claim, inflating damages, or fabricating events to justify a claim.

The essence of this definition revolves around the intentionality behind the act; the perpetrator knowingly falsifies details to secure a financial advantage. This intentional deceit is what sets it apart from other forms of misinformation or misrepresentation, such as negligence, which may not involve an intent to deceive.

While there are other forms of inappropriate behavior regarding claims—such as claiming benefits without being eligible or failing to present accurate information—these do not necessarily involve the willful intent to deceive that characterizes fraud. Similarly, overstating the value of a claim can be a part of fraudulent behavior but does not capture the broader definition of fraud which is fundamentally rooted in the act of misleading with malicious intent.