Life &Amp; Health Insurance Fraud

Life & Health Insurance Fraud
Insurance Fraud is a felony. Claims are either false or exaggerated, and most times certain information are held back in order for the claimant to
obtain the benefits that the insurance company has to offer and to avoid certain penalties. In this event, the claimant can be fined $150,000 or 10
years in prison. (Associated Content, 2007). It has been stated that at least %10 of all insurance claims has been fabricated and in North America the
insurance industry pays out more than $30 billion in fraudulent claims. (Fraudcast, 2009) One of the most common insurance fraud would involve life
insurance. Life insurance is a type of coverage that pays benefits upon a person's death or disability.(Answer, 2009) This will financially... Show more
content on Helpwriting.net ...
(KPMG Forensic, 1995) In conclusion, the amount of loses in an insurance company has caused a lot of damaged, financially wise and the lost of
holding up a reputation of being trustworthy insurers. When claims and fraud becomes difficult to investigate, insurance companies would turn to
special investigation unit (SIU) (KPMG Forensic, 1995) which consist of relevant personnel such as former police officers and experienced claim
handlers. All in all it is pretty hard to mitigate insurance fraud when there are always ways of cheating the system and insurers having to give the
benefit of the doubt of their clients to follow their policy. Reference List: Associated Content, (2007) Retrieved March 18th, 2009, from (http:/
/www.associatedcontent.com/article/167337/know_the_types_of_insurance_fraud.html) Fraud Squad TV, (2009) Retrieved March 19th, 2009, from
(http://www.fraudcast.ca/docs/Insurance_Claim_Fraud.php) Answers.com, (2009) Retrieved March 19th, 2009, from (http://www.answers.com/topic
/life–insurance ) Coalition Against Insurance Fraud, (2009) Retrieved March 19th , 2009, from (http://www.insurancefraud.org/stats.htm) Wikipedia,
(2009) Retrieved March 19th, 2009, from (http://en.wikipedia.org/wiki/Beneficiary) CBS News (2007) Retrieved March 19th , 2009, from (http:/
/www.cbsnews.com/stories/2007/12/08/world/main3593846.shtml) BNET(1994) Retrieved March 19th, 2009 from (http://findarticles.com/p/articles
/mi_m1355/is_n8_v86/ai_15547814)
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Insurance Fraud
Insurance Presentation Report
Report on: The Development of the Brazilian Insurance Industry
Submitted to: Dr. BogusЕ‚aw Bamber
Presentation date:
BBA Finance & Accounting
Semester 5, Academic year 2013–2014
Jamir Issa de Oliveira 25139 .........................
Vinicius Appolinario 25545 .........................
Executive summary
The aim of this report is try to evaluate how the insurance industry has developed in Brazil since it began its operation in 1808, operating in the
begging only with maritime insurance through company named Boa FГ©. During that time Brazil was still a colony of Portugal and Boa FГ©
Company had the role to insure ships transporting valuable goods ... Show more content on Helpwriting.net ...
In 2012, that market grossed U.S. $ 252.4 billion in direct premiums of insurance, health insurance, pension contributions and savings bonds. Such
awards and contributions served to increase provisions amounting to R$ 420 billion, which represented 5.69 % of GDP. Provisions have also secured
the payment of compensation of claims, welfare benefits and redemption of pension plans and capitalization of R $ 135.2 billion in 2012 (3.05% of
GDP). The importance of the sector exceeds, by far, the numeric expression. Indeed, everyday life, as we know since the Industrial Revolution, would
be impossible without insurance. The companies could not take risks as they do at present, so your investment would be severely restricted and, with
them, the future expansion of the economies. Entire markets would collapse: just imagine what would happen with the sale of cars, with the credit
market and the trade if there was not the support of insurance. The insurance industry, increasingly supplements the State in providing critical services
in health and social security, and in doing so, allows the state to focus attention and resources on meeting the needs of the poorest sectors of the
population.

Nowadays The Brazilian insurance industry is living it golden ages. Brazil for the past two decades has become one of the most attractive places for
insurance

Brokerage Insurance Fraud
Millions of people have been lured into investing their hard–earned money based upon fake and misleading information. Unfortunately, the results are
often dismal and many investors have lost their life savings. Sadly, the financial planning industry is rife with advisers and brokers who are willing to
deceive their customers for personal gain. That said, the brokerage industry is regulated by federal and state law. Acts of professional misconduct or
outright fraud are illegal. Below, we'll explain the 3 most common types of financial planning fraud to watch for.
Tip 1 – Churn And Burn
Some financial advisors are compensated through the commissions earned on the purchase or sale of securities. If tempted, some might engage in
excessive buying

Health Insurance Fraud Essay
Faking a death is the most common type of life insurance fraud and has even been the plot of many movies, books and shows; although it is difficult
to pull off. This occurs after a person takes out a life insurance policy on their self and after a few months of it being in effect they disappear and are
declared dead. Then the beneficiary, a family member or spouse, then attempts to collect the life insurance policy
"Double–billing" is a scheme that is common in health insurance fraud. Doctors will bill for treatments that were not rendered or medically necessary
as well as billing for a different service that is covered under the patient's policy instead of billing for a treatment that is not covered. Patients may not
even realize they are ... Show more content on Helpwriting.net ...
Insurers can refuse to pay claims or delete claims, deny or cancel coverage as well as underpay medical expenses. Fraudulent insurance companies
can also collect premiums and pay for inexpensive care before disappearing if a large claim is filed. It has also been known for companies to look
through insurer claims to intentionally drop them saying the insurer did not disclose previously.
One of the most targeted insurance lines is auto insurance fraud. There are many known schemes that take place in this fraud that can vary in
seriousness and complexity. There are small schemes to defraud; filing multiple claims for a single injury, filing claims for vehicle damage or injuries
that were not caused by and auto accident and padding the cost of repairs. The schemes can become more complex involving staged accidents, faking
injury or falsely reporting a stolen vehicle.
Other schemes in auto insurance fraud occur mostly to avoid paying higher premiums. People might register their car in a different town so they
have cheaper rates. It is also common for fake primary drivers to be listed to avoid a bad driving record or young drivers that are indeed the sole driver.
Another scheme is a policy holder reporting a false auto insurance claim that occurred before the policy period

Workers Compensation Fraud
Whether you're starting a new business or already in an established business, you need to know the basics of workers' compensation insurance.
Almost every business that has employees other than the owner is required by state law to carry workers' comp. But you need to be careful in
choosing a policy. The fact is many insurance companies can get remarkably tricky when it comes to writing policies– in their bag of tricks are such
ploys as classifying the type of work your employees do incorrectly, miscalculating so–called modification factors, and making a variety of other types
of mistakes which, oddly enough, result in insurance costs to you that are higher than they need to be.
Beyond needing to hold your own against your workers' compensation insurance carrier, there's another reason to take a few minutes to learn more
about this type of insurance, namely, fraud. Workers' compensation fraud is the second largest category of white–collar fraud in the United States today,
second only to income tax evasion. According to industry observers, fraud occurs in almost a fourth of all claims. It can take the form of employee
fraud (an employee who's been in an accident claiming to be injured more seriously than he/she really is), ... Show more content on Helpwriting.net ...
Workers' compensation is regulated primarily by the states (and Washington DC) so there are 51 separate sets of rules which govern benefits,
premiums, and coverage. However, a so–called "rating bureau" called the National Council on Compensation Insurance (NCCI) has developed a
manual used by many states to regulate how insurance companies calculate your rates. NCCI states rely almost completely on this manual, while some
other states have developed their own manuals. For example, Nevada sticks closely to the NCCI manual, whereas California has developed its own

Medical Fraud And Insurance Crime
As we all know medical fraud and insurance fraud is both a crime, however that does not stop individuals from committing it. Back in 2015 the FBI
arrested 46 doctors and nurses across the country. Which was also the largest Medicare fraud bust ever. The individuals billed Medicare for $712
million worth of patient care that was never given. Most of the doctors was ordering durable medical equipment and sending them across the country to
patients that did not request nor need them. Since 2007 The DOJ'S Medicare Fraud Strike Force team has gotten over 2,300 people who committed
fraud for more than $7 billion dollars. Thanks to the Affordable Care Act there donation has happen catch more individuals . You would think that
committing fraud is

Essay On Workers Compensation Fraud
Workers' compensation fraud is often difficult to prove. Even when a claim is denied, it can be challenged by an attorney, and an insurance company
can find themselves paying out compensation to someone they suspect of fraud. In some cases, there may be no suspicion of fraud, but the discovery of
fraud occurs accidentally because the fraudster has made a mistake. The following are four mistakes that are made by those who are defrauding
insurance companies because of fake injuries and how our services can help in documenting them.
They get another job
While collecting workers' compensation, an individual may find other work. Getting a check for sitting at home is not enough for some people.
Without any physical injury, a person may want to earn... Show more content on Helpwriting.net ...
This is a classic mistake that a fraudster makes. After their claim is approved and they begin to receive money, they let their guard down. They can
be seen doing things that are supposed to be impossible. An example would be a person with a back injury, not capable of lifting more than a pound
of weight, seen lifting heavy items from their car after returning from the store. In some cases, people claim limited mobility, but can be seen walking
around or even running. These types of mistakes can be caught on video, and the fraudster will have been caught.
They post pictures of their activities on social media
People enjoy social media, but they fail to understand how wide spread their postings can circulate. One of the biggest mistakes a fraudster will make
is posting pictures of a vacation they took or other fun activity they recently engaged in that is impossible for them given their claim of injury. It is true
that there is security for some these sites, so the information is private and limited to a small circle of people, but fraudsters often make the mistake of
not taking security precautions.
Tipsters are

Court Cases Of White Collar Crimes
White collar crimes are offences in which are financially driven and executed by those in business and government professions. These crimes are
found to be less disgraceful in the eyes of justice due to the fact that they are non violent acts. However, the impact this unlawful act provides society
with is far from the minor misdemeanor that the law projects it to be. Hospitals, and Insurance companies are the most frequent offenders of white
collar crimes. Crimes are committed by individuals who are personally affected by the negligence of these fraudulent facilities and their actions.
Frequently the media depicts insurance fraud to be most commonly committed by individuals who invest in the insurance firms for promising
protection and ... Show more content on Helpwriting.net ...
This crime may not be violent or even considered dishonourable, but none the less individuals are still affected by the actions taken to commit
these crimes. Fraud affects the economy as a whole and generates gaps. Crime rate increases after white collar crimes occur. Individuals who do
not have sufficient funds will use Morton's mode of adaptation being innovation to make ends meet. This is when an individual understands the
societal goals and expectations however, make their own means to achieve them. In John Q, John tried to conform to society's norms and goals by
raising the funds in an honest manner. When he finds out his insurance company has changed his contract unknowingly and will not be able to
provide him with any financial support for his son's heart transplant he decides to adapt to the mode of innovation. His way of innovating to
achieve his means was to take an emergency room hostage until his son was put on a donor list. This provides evidence that individuals who are not
properly taken care of by systems set in place to provide protection will resort to their own modes to adapt to the situation. A survey was done among
almost 400 homeless people and 28% of the women had provided unwanted sex in order to find shelter meanwhile 1 in every 5 homeless individuals
had committed a prison punishable crime in order to find shelter.

Case Study Of Counter Fraud In The Insurance Company
Today's insurance market competitions in Malaysia is at a high level. Refers to the annual report of life insurance in Malaysia as prepared by Life
Insurance Association of Malaysia stated that life insurance industry recorded growth in 2015 which it provide the insurance coverage amounting to
RM1.24 trillion which this amount is 6.2% much higher than the RM1.17 trillion in 2014
Hence, one of the primary goals for service base business like insurance is to make sure that the sale strategy meet high level of customer satisfaction. In
competing with the insurance market, the insurance companies (Etiqa Takaful, Zurich Takaful, AIA Insurance, Allianz Insurance, Takaful Ikhlas,
Takaful Malaysia, Prudential Takaful) intent to create a competency characteristics of their product or services and and also the quality of salesperson
or agent. According to Kuster and Canales (2011), one of the most important tools to a firm's survival is the salesperson because he is the one who
deal with the customers. The salesperson helps in ... Show more content on Helpwriting.net ...
Counter Fraud in the Insurance Company: A Case Study of Malaysia. University of Portsmouth] It occurs and may be committed at different points in
the transaction by different parties such as policy owners, third–party claimants, intermediaries and professionals who provide services to claimants.[
Bank Negara Malaysia 2016] The nature of these frauds may vary from an inflated or exaggerated value of a legitimate claim to a completely
fabricated or bogus claim where losses never really occurred. We may be argue that this kind of dishonesty and unethical practices among the
salesperson or agents may because of the lack of training and skills development among them. They may have to attend for a specific training in order
to cater this fraud problems in this

Law And Ethics : Dental Fraud For Profit
Law and Ethics: Dental Fraud for Profit
Tessina Jernigan
DA
10/21/2015
Dentistry is a unique and beautiful healthcare field. We as individuals whom work in the dental office can impact the lives of those around us. There
are those who abuse the system, instead of having the patient's best interest at heart. This causes many patients to become fearful, and loose trust
within the professionals whom work in the dental field. Not only are there ethical issues that arise across the country; there are legal issues as well. It
is common that the two go hand–in–hand. Dental insurance fraud is one of the most common hardships that people come across. Dental fraud not
only affects the company that pay for the care, it affects the business in which it occurred, it affects those who pay for the insurance, and ultimately
the patient. The patient should be the primary concern of the whole dental team. I have personal experience with dental professionals abusing dental
insurance. I had unnecessary treatment performed on healthy teeth, just so the office would use every bit of available insurance, and then some more
that I was responsible for. It was very traumatic event for myself. I went from having a few filings to needing an inlay, to then being told I needed a
root canal, after the individual got the inlay stuck in my tooth. I refused the root canal treatment. I was numbed seven times that day, and by the end of
it all I felt everything. It made no sense at all.

The Pros And Cons Of Ethical Dilemmas
The case represents an unethical dilemma. The case describes about a customer in a supermarket store who slipped and seriously got injured. The
customer saw the sign; however, she chose to disregard the warning sign about the wet floor. She incurred serious injuries that lead to large hospital
bills and the person missed several months of work. The worst part is that the she does not have insurance to pay hospital bills, nor has any source of
support. In this situation, the injured customer's attorney is going to sue the supermarket store for the reparations. Nevertheless, the attorney suggested
to the employee to testify that there was no sign in place to warn that the floor was wet and if the employee would do what the attorney told her to do,
then the payment would be handled by the insurance company. However, the attorney states that the state law in which this incident occurred, requires
the supermarket to place a ... Show more content on Helpwriting.net ...
One of the first rationalization in this situation is to have sympathy or sympathize with the injured customer. For instance, the insurance company can
afford the loss, while the injured customer cannot. Although, it could be true that the insurance company can afford the loss, while the injured
customer cannot, this would still be insurance fraud. Under the positive law this is known as illegal and unethical. Second rationalization in this
situation is the use of another state law in the case. For example, in the place where the incident occurred, the law states that placing a warning sign is
inadequate. It could be true in different states, but we must obey the law in which the states we live in. The truth is that the customer deliberately chose
to ignore the warning sign and thus leads to injuring the customer

Essay on Fraud, Waste and Abuse Research Project
Fraud, Waste and Abuse Research Project
Combating fraud in the private sector is a difficult task. Trying to combat fraud in the public sector is daunting. In 1999 15.7% of the American
workforce were employed by a government entity (federal, state, and local).[1] Mirroring society, government will have its share of perpetrators. The
difference from the private sector is in the scope of the fraud committed, the loss of the public trust, the blaring headlines from news media, and
difficulty in making necessary changes to combat the problems.
A good definition of Fraud, Waste and Abuse (FWA) can be found in U.S. Air Force Regulations and can be applied to any government (or private)
organization, it states:
Fraud–"Any ... Show more content on Helpwriting.net ...
Everyone has seen news headlines when someone is caught in a multi–million dollar scam. The public takes note when the government spends $400 on
a single hammer or $660 on a toilet seat.[4] But what about Joe M. Ployee who takes a few pens or pencils or other office supplies home from his job
at the Department of Labor? Or the city engineer who runs personal errand in his government vehicle during work hours? It is possible that these
employees didn't know they were committing FWA. Education about these transgressions must be an essential part of any training for public
employees, elected, appointed or hired.
Waste
All organizations strive to streamline operations, which in turn should lead to saving money. Fighting the wasting of resources should be a top priority
for any government entity and particularly for supervisors, managers, and executives. In the public sector this is particularly true because the citizens
in effect supply the resources wasted. The public trust should not be abused by careless or needless spending. However, because of the bureaucratic
nature of any government agency, some waste cannot readily be avoided. The laws and regulations that have been duly enacted to secure justified
expenditures in and of themselves can cause waste.
Several examples of waste can be found at the

What Is The Ponzi Scheme?
Bernard Madoff was able to pull off the largest white collar fraud, in the history of investment trading. His fraudulent activities were later discovered
in 2008, when his firm begin to crash. Mr. Madoff was able to gain over $65 billion of investment funds through conducting the Ponzi Scheme.
According to Ferrell , Fraedrich and Ferrell (2015), self destruction of the Ponzi scheme results rapidly as the ability to continuously recruit new
investors dwindle. After the arrest of Mr. Madoff in 2009, further investigation determined that there were approximately 167 victims of the Ponzi
Scheme (Lewis, 2011). Several of the victims initially were not convinced that they fell victim, while others committed suicide after discovering that
they lost

Accounting Frauds: ZZZZ Best Company, Inc
ZZZZ Best company is one of the biggest examples of Accounting Frauds. The founder of ZZZZ best was Barry Minkow. He was a very smart
young entrepreneur when he started the company. He was involved in credit card forgeries prior to starting his own carpet cleaning business "ZZZZ
Best Company". Minkow began his business with small carpet cleaning jobs and he became a multimillionaire in a very short period of time. Minkow
met a person named Tom Padgett at Los Angeles Health club. This was the beginning of Minkow's bigfraud scheme. Padgett was the insurance claims
adjuster and Minkow became his friend. After becoming Padgett's friend, Minkow thought of using his friendship with him to make profit in his
business. He convinced Padgett to ... Show more content on Helpwriting.net ...
It was stated in the article that Minkow was involved in credit card forgeries at a very young age prior to starting his own company. This was the time
when investors and others associated with ZZZZ Best started to step back. This was a major reason that concerned Ernst & Whinney about ZZZZ Best.
In addition to the news article, Ernst & Whinney also received a letter from an anonymous writer, who warned them about the fraud in ZZZZ Best. It
was stated that the assets of ZZZZ Best are not properly reported and the insurance restoration contacts were all fraudulent. Ernst & Whinney
questioned Minkow about the fraudulent Insurance restoration contracts but Minkow was able to prove them that the contracts exist. He gave them the
address of a building that was being restored and he bribed the security guard and others to tell them that the building is contracted under ZZZZ Best
Company. This was sufficient to prove Ernst & Whinney that the contracts stated in ZZZZ Best financial statements were accurate and they did exist.
In spite of that, Ernst & Whinney did not audit the ZZZZ Best in 1987 due to Minkow's bad reputation and the news about the fraudulent contracts.
Minkow was successful in getting away from another audit and continued operating his firm with all the fraudulent contracts and other credit card
frauds. According to my understanding of this case, I think that the auditors should be

The Pros And Cons Of Utilitarianism
Utilitarianism argues that the consequences of an action determine whether the decision is right or wrong. When the decision produces results that
benefit a lot of people is considered appropriate (Timmons, 2002). The effects of an action that are important are those that produces positive results,
which means that the types of action selected should yield a positive result. The purpose of morality is to increase the number of good deeds such as
happiness and pleasure. The morality should be able to reduce the number of bad things such as unhappiness and pain from occurring in society. The
utilitarian principle argues that the moral worth of an action is determined by an overall utility that increases pleasure and happiness. The total utility,
which is the measure of desirability and satisfaction of an action needs to bring happiness to the highest number of people. The theory argues that there
should be no discrimination. Based on utilitarian principles, which argues that benefit of an action should help the largest number of people, Antonio
should resign from his position. This is because when the matter is reported to the authorities, he will cause the reputation of the company to sink.
Therefore, many people will lose their employment. On the other hand, failing to report the matter will mean that insurance companies will continue to
make a loss to benefit a single company or an individual. Antonio should ask Kevin should consider reporting the matter to prevent more

The Issue Of Protection Is Needed For The World Today
The generation in today society has to understand that protection is needed for the world today because the people need to feel safe and comfortable.
In every state, the requirement of protection is considered a law and is different extremely in each 50 state. Most people abide by the protection law
because it's the ethical decision to do, but some people do the opposite for their own egocentric reasons. In Mississippi (American), consumers have
protection from unscrupulous sellers and adequate information to make wise marketplace choices (Norrgard, 1988, p.61). A young Mississippi woman
went to every business and individual advertising her new product of shampoo for women and men. She publicly announced to the entire consumer that
the ... Show more content on Helpwriting.net ...
This means that the act was designed to protect the victims of customer who was being fraudulent and deceptive. This law also created the Federal
Trade Commission (FTC), an independent regulatory agency, to enforce these provisions. It grants the Commission civil, but not criminal,
jurisdiction to pursue unfair and deceptive market practices (Norrgard, 1998, p.105).Thomas Aquinas said it best, "If the seller be aware of a fault in
the thing he is selling, he is guilty of a fraudulent sale, so the sale is rendered unlawful. Another defect is in respect of quantity which is known by
being measured: wherefore if anyone knowingly makes use of a faulty

Health Insurance Fraud Essay
According to Roger Feldman, Blue Cross Professor of Health Insurance on the University of Minnesota, one of the main motives that medical fraud
is this type of general exercise is that almost all of the parties concerned discover it favorable in some way. Many physicians see it as necessary to
offer satisfactory care for their sufferers. Many sufferers, even though disapproving of the concept of fraud, are sometimes extra inclined to simply
accept it when it impacts their own hospital treatment. Program administrators are regularly lenient on the problem of insurance fraud, as they want to
maximize the services in their providers.[17]
The most not unusual perpetrators of healthcare insurance fraud are fitness care providers. One reason for ... Show more content on Helpwriting.net ...
One tactic fraudsters use is to drive to a busy junction or roundabout and brake sharply inflicting a motorist to power into the again of them. They
claim the other motorist was at fault because they have been driving too rapid or too close in the back of them, and make a fake and inflated declare
to the motorist's insurer for whiplash and damage that can provide the fraudsters as much as ВЈ30,000.[24] In the Insurance Fraud Bureau's first yr or
operation, the usage of information mining initiatives uncovered insurance fraud networks and caused seventy four arrests and a five–to–one return on

Council Compensation Claims
Council compensation claims
The fraud concerning claims from the councils' insurers assume staging damages blamable on the local authorities (in most cases falls and journeys on
council owned land) or inflating the cost of current damages.[40]
Detecting insurance fraud
The detection of coverage fraud commonly occurs in steps. The first step is to perceive suspicious claims that have a higher possibility of being
fraudulent. This can be carried out by computerized statistical evaluation or by means of referrals from claims adjusters or coverage dealers.
Additionally, the public can offer guidelines to insurance companies, law enforcement and other businesses regarding suspected, located, or admitted
coverage fraud perpetrated by other people. ... Show more content on Helpwriting.net ...
According to Alfred Manes, the majority of belongings insurance crimes involve arson.[37] One reason for this is that any evidence that a hearth
changed into started by arson is regularly destroyed via the hearth itself. According to the USA Fire Administration, in the United States there have
been approximately 31,000 fires as a result of arson in 2006, ensuing in losses of $755 million.[38] For example, the Moulin Rouge Hotel in Las Vegas
was struck by way of arson twice within six

Fraud As A Civil Wrong
Fraud is unfortunately a subject that many companies and even people have problems controlling. Fraud is defined as deliberate deception to secure
unfair or unlawful gain. It is said that fraud is both a civil wrong where a fraud victim may sue the fraud perpetrator to avoid the fraud or recover
monetary compensation and a criminal wrong where a fraud perpetrator may be prosecuted and imprisoned by government authorities. There are many
purposes of fraud that may include monetary gain or other benefits. As a civil wrong in common law jurisdictions, fraud is referred to as a tort. It is
stated that while the precise definitions and requirements of proof may vary among jurisdictions, the necessary elements of fraud as a tort generally are
... Show more content on Helpwriting.net ...
In cases of fraudulently induced contract, fraud may serve as a defense in a civil action for breach of contract or specific performance of control. As a
criminal offense in common law jurisdictions fraud takes many different forms, some general and some specific to certain categories of victims. The
necessary elements of perhaps most general form of criminal fraud, theft by false pretense, are the intentional deception of a victim by false
representation or pretense with the intent of persuading the victim to part with properly and with the victim parting with property in dependency on the
representation or pretense and with the perpetrator intending to keep the properly from the victim. It also reads that in civil law systems and other
legal systems the concept of fraud seems to exist, but its elements and application may or may not vary significantly from the common law system
concepts discussed. There are many types of fraudulent acts. Fraud can be committed many ways which include mail, wire, phone, and the internet
such as computer crimes and internet fraud. Internet fraud is something that we have all heard of many times before. With international dimensions of
the web and ease with which users can hide their location , the difficulty of checking indentity , and the simplicity with which hackers can divert
browsers to dishonest sites and steal credit card details have all contributed to the very rapid growth of internet

Perferene Patent Press Release
Out of Network Vision Services Claim Form
Claim Form Instructions Most EyeMed Vision Care plans allow members the choice to visit an in–network or out–of–network vision care provider. You
only need to complete this form if you are visiting a provider that is not a participating provider in the EyeMed network. Not all plans have
out–of–network benefits, so please consult your member benefits information to ensure coverage of services and/or materials from non–participating
providers. If you choose an out–of–network provider, please complete the following steps prior to submitting the claim form to EyeMed. Any missing
or incomplete information may result in delay of payment or the form being returned. Please complete and send this form to ... Show more content on
Helpwriting.net ...
Alaska: A person who knowingly and with intent to injure, defraud, or deceive aninsurance company files a claim containing false, incomplete, or
misleading information may be prosecuted under state law. Arizona: For your protection Arizona law requires the following statement to appear on
this form. Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal and civil penalties. Arkansas:
Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and confinement in prison. California: For your protection California law
requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a
crime and may be subject to fines and confinement in state prison. Colorado: It is unlawful to knowingly provide false, incomplete, or misleading facts
or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment,
fines, denial of insurance and civil damages. Any insurance

Research Paper (Bah Fraud and Larceny)
|CATEGORIES |POINTS TO BE GRADED ON: 100 PTS TOTAL |POINTS |
|INTEREST | |(5) |
| |Many everyday scenarios in the Military are easily overlooked when they do not| |
| |directly involve you. This research project explores the common crimes of | |
| |larceny and fraud as it pertains inside the military. | |
| ... Show more content on Helpwriting.net ...
| |
| | | |
| |This is the fraud that is used more commonly in the military. Soldiers use | |
| |different mechanisms in the military finance department to attempt to receive | |
| |more money than they are authorized to receive, particularly for the Basic | |
| |Allowance for Housing (BAH). | |
| | | |
| |Wire/Mail fraud – | |
| |Using any means of communication or information delivering system such as | |
| |television, phones, computers or mail for the purpose of selling items not | |
|

Zzzz Best
Case 4–6
ZZZZ Best*
The story of ZZZZ Best is one of greed and audaciousness. It is the story of a 15–year old boy from Reseda, California who was driven to be
successful regardless of the costs. His name is Barry Minkow. Minkow had high hopes to make it big – to be a millionaire very early in life. He started
a carpet cleaning business in the garage of his home. Minkow realized early on that he was not going to become a millionaire cleaning other
people's carpets. He had bigger plans than that. Minkow was going to make it big in the insurance restoration business. In other words, ZZZZ Best
would contract to do carpet and drapery cleaning jobs after a fire or flood. Since the damage from the fire or flood probably would be ... Show more
The bank didn't know it because some of the checks that Minkow had written before the visit to bank number two had not cleared his account in bank
number one. It wasn't long thereafter that Minkow realized he could kite checks big–time. Not only that, he could make the transfer of funds at the end
of a month or a year and show a higher balance than really existed in bank number one and carry it on to the balance sheet. Since Minkow did not
count the check written on his account in bank one as an outstanding check, he was able to double–count.
Time to Expand the Fraud Over time, Minkow moved on to bigger and bigger frauds like having his trusted cohorts confirm to banks and other
interested parties that ZZZZ Best was doing insurance restoration jobs. Minkow used the phony jobs and phony revenue to convince bankers to make
loans to ZZZZ Best. He had cash remittance forms made up from non–existent customers with whatever sales amount he wanted to appear on the
document. He even had a co–conspirator write on the bogus remittance form, "job well done." Minkow could then show a lot more revenue that he was
really making. Minkow's phony financial statements enabled him to borrow more and more money and expand the number of

Zzzz Best Case Study
ZZZZ Best, a carpet cleaning company, was founded by Barry Minkow in 1982 in Reseda, California. Barry always wished to succeed in business
and become the American Dream of financial success. When he was nine years old, he worked as a telemarketer in a carpet–cleaning business. Six
years later, when he was only sixteen years old, he began his personal carpet business in his parent's garage in Los Angeles (ZZZZ Best Case Places
SEC Procedures Under Scrutiny). He had three employees and was considered the most successful teenage businessman in the United States. Minkow
discovered he could become very successful in business through insurance restoration. He would file a claim for restoration of the business from a
natural disaster. ZZZ Best was profitable in carpet cleaning, yet 85% of the business profits came from fraudulent insurance restoration business.
Minkow used insurance restoration as a cover for the cost of the money he was acquiring illegally (Taylor). Shortly after, insurance restoration became
the major source of revenue for the company's income, rather than carpet cleaning. Minkow's dream in becoming successful in business caused him to
become more innovative. He started using his counterfeit financial statements to persuade wealthy entrepreneurs to invest in ZZZZ Best. Ultimately,
Minkow realized that the crucial scam would be to make his company public. This would enable him to utilize the bank accounts of investors
nationwide. By becoming a public company,

Fraud: Early Warning Signs of Fraud Essay
The early warning signs of fraud are, usually, always ignored. There are warning signs for every type of fraud out there. To understand the warning
signs of fraud, we must first know what fraud is. Fraud is the intent to trick someone or lie to someone in order to receive financial gain. This
definition varies depending of the type of fraud used, but the person committing the fraud is always looking for financial gain. There are many types
of fraud out there. You have Medicare fraud, internet fraud, mortgage fraud, loan fraud, tax fraud, embezzlement, forgery, insurance fraud, and
marriage fraud. These are only a few types of fraud. There are many more types of fraud out there and new types of fraud are being committed every
day. This... Show more content on Helpwriting.net ...
Tax payers are putting money into Medicare throughout all of their working life and are expecting it to be there to help provide for the elderly
who need it. The physician never pays taxes on any of the money that Medicare has sent him. Patients that see that physician may feel less secure
and switch to other doctors if a fraud has occurred. One way this fraud is detected is when, "the unknowing physician gets a call from the Internal
Revenue Service" (3). For the fraud to occur, all the thief needs is to obtain the physician's ID or obtain a physician's prescription pad. The
physician's ID, business address, and medical license can be obtained through hospital files. The prescription pad can be obtained at the physician's
office. Once the physician's ID, business address, and medical license are stolen it can be sent to, "the state health department to obtain Medicaid
provider numbers" (3). The thief will also change the address of the business. Patient information is also important to be able to bill Medicare or
Medicaid. The reimbursement checks are sent to the new addresses and the thief forges the physician's signature. The thief may use the prescription
pad to prescribe unauthorized medicines. Sham clinics are also set up by thieves to write illegal prescriptions. A few warnings that a fraud is occurring
is when you notice prescription pads are missing. If the Internal

Barry Minkow
Barry Minkow – Misrepresentation and Ponzi in 1987 Establishment of ZZZZ Best Company When he was a sophomore in high school, Barry
Minkow founded a carpet cleaning company – ZZZZ Best Company in his parents' garage. At that time, the carpet cleaning industry has few entry
barriers and all Minkow needed was a small amount of start–up capital. However, he soon found out that his firm was actually tough to survive in the
industry as the ease of entry means fierce competition. The young man encountered a series of trouble: bad checks, complaints from customers, urge
for payment from suppliers and finally the shortage of working capital. Not surprisingly, the bank refused to loan money to his low profit margin
company. Minkow would like to... Show more content on Helpwriting.net ...
Minkow became a billionaire and an American success story. By February 1987, on paper, the company– which Minkow claimed had about 1,300
employees in some two dozen offices – was worth nearly 300 million dollars. Minkow 's personal worth reportedly topped $100 million. He began to
live a luxury life including driving a red Ferrari with a "ZZZZ BEST" license plate and appearing on Oprah. Minkow 's business had been clearly a
Ponzi scheme. He promised investors highly returns on the insurance restorations business, but in reality, investors were being repaid with money from
new investors. Some of the loans were negotiated at outrageous rates of interest so that they were obtained fast enough to pay off earlier loans. ZZZZ
Best did operate its carpet–cleaning business which differed itself from a typical Ponzi and the carpet–cleaning division won high marks for its
quality.iii However, its insurance restoration division was totally a phony department and little real business existed. Fooling the auditors As the
company went public, ZZZZ Best was subjected to the audit of its financial statement. George Greenspan, the performer of the audit, reviewed the
copies of the insurance restoration jobs and then confirmed its existence in the report to SEC. He also calculated various kinds of ratios of the
company and concluded that they were in line with the industry

Insurance Career Goals
Identify the career goals for which you are preparing. One of the facets of demonstrating a level of commitment to the future from a personal, and even
professional standpoint, is setting goals. It is important to set reasonable and attainable goals. Overreaching can result in frustration and
disappointment. With that said, I have set one short term goal, to become an insurance fraud investigator, and one long term goal in mind for my career
in the insurance industry. Ultimately, I would like to obtain employment, either with my current company or even with a competitor to become an
insurance fraud investigator. According to the Bureau of Labor and Statistics, investigators are not required to be licensed in any state because they can
work ... Show more content on Helpwriting.net ...
My employer pays for my college education. I realize how fortunate I am to be given this opportunity. My classes have to be approved by my
immediate supervisor, and all courses must be relevant to my job or prospective job. This will be of great assistance as I complete my Bachelor's
degree. When a person has a Bachelor's degree, more doors open – not just within my company, but within life in general. The position I am seeking
requires a bachelor's degree in criminal justice or a related field such as Criminology. I have just earned my Associates degree in criminal justice, and
have begun the process of earning my Bachelor's degree. Once I have my degree, I can interview for an open investigator

The Corporate Con Essay
Courtney Newcomer
Professor Poirier
Acct 3040
November 2, 2011
The Corporate Con: The Internal Fraud and The Auditor In the movie the Corporate Con: The Internal Fraud and the Auditor there were several
different people who seemed like your everyday "Joe," but were actually criminals who committed fraud. Some of the frauds committed in this movie
were: Cash Fraud, Accounts Receivable Fraud, Expense Fraud, purchasing fraud, and corruption. Focusing on two individuals Pam and John, each of
these criminals committed either cash or accounts receivable fraud. Pam was a graduate from high school who found work soon after graduation. She
felt she wasn't getting paid enough for her work so she started stealing cash from the ... Show more content on Helpwriting.net ...
There are several methods used in detecting cash fraud which are usually included in most cash audits. Some of the methods used are: Bank
reconciliations, cutt–off statements, surprise cash counts, customer complaints, altered or missing documentation, journal entry review, review and
analyses of decreases in gross sales or increases in returns and allowances, and analytical reviews. The method used in detecting Pam's fraud was a
surprise cash count.
Surprise cash counts often bring up situations of employees "borrowing" money or floating small loans also called "swapping." It is crucial that when
doing surprise cash counts that it be done often but on an irregular and unannounced basis. Also, if employee checks are included in the cash drawer
or register, this may be an indicator that employees are "swapping" checks for cash.
In the prevention of cash frauds it is important to have a segregation of duties. Cash fraud is more likely to happen if one person has control over the
entire accounting transaction. Each of the following duties and responsibilities should be segregated: cash receipts, bank deposits, bank
reconciliations, and cash disbursements. If one person has the ability to do all of these themselves there is a high risk that fraud can and will occur.
Surprise cash counts are very useful in fraud prevention if the method is used correctly. Employees should know that cash will be counted, but that its
sporadic and

Why Do Workers Pay Fraud
Workers' Compensation Insurance Fraud
Whether the employee or employer provides false or misconstrued information to insurance companies, workers' compensation fraud is a serious crime.
What is workers' compensation fraud?
Workers' compensation fraud occurs when either an employer or employee knowingly makes false statement(s) or hides information in order to receive
benefits or to prevent someone from receiving said benefits even when deserved.
How can an individual commit workers' compensation fraud?
Faking injury/injuries to receive paid time off work.
Exaggerating the seriousness of an injury to receive more paid time off.
Falsifying the location where the injury took place.
Using the paid time off to obtain a new job and lying to the insurance company about being unable to return to the ... Show more content on
Helpwriting.net ...
Under the Ohio Revised Code concerning workers' compensation, violators face either a misdemeanor charge, a felony in the fifth degree, a felony in
the fourth degree or a felony in the third degree depending on the amount of monetary value associated with the incident. Additional side effects of
fraud include court costs, legal fees, incarceration time, fines and the negative stigma of being a convicted felon throughout the rest of life.
Suspect that you or your employer may be wrongly accused of a workers' compensation fraud case? Call Bentoff & Duber for a consultation to discuss
your options for seeking justice.
For more information about workers' compensation, check out the following resources:
The five mistakes people make when filing workers' compensation claims
Does workers' compensation cover me if I'm injured outside of work?
Can I be fired for hiring an attorney or filing a workers' compensation claim?
What is the statute of limitations for workers' compensation in Ohio?
Do I have to take any time off work to qualify for worker's compensation benefits?
10 misconceptions about workers'

The And White Collar Crime
1. Literature Review
Crimes have been occurring in our society for many years and recently the occurrence of non–violent crimes has increased dramatically. Traditional and
white collar crimes have two traits in common, an objective and a modus operandi, but the major difference is that a white collar criminal has a plan
and also the ability, knowledge and technology to execute it (Nevis, 2012).
White–collar crimes can occur at any occupational level and affects all parts of society, from big businesses to individuals. Some associate the
definition of white–collar crime mainly to economic crime, but others include corporate crimes like environmental law violations and health and safety
law violations (Barnett, 1999). It is interesting to note that corporate crimes such as environmental pollution typically involve corporate personnel on
various levels for purposes of implementation, from CEOs to low level workers (Payne, 2013). Overall this project will deal with environmental and
white–collar crime outlining the similarities and differences between those.
1.1 White–collar crime
1.1.1 Definition and theory
Recently the issue of white–collar crime has gained a lot of attention and it is quite common to notice such cases in any part of the world. The term
itself is rather old as it was coined by Edwin Sunderland in 1939 and white–collar crime is defined as crime committed by a person of respectability
and high social status in the course of his occupation (Payne, 2013). The

American General Life Insurance Fraud Case Study
SRM received notification from the New Jersey Department of Human Services that they are investigating financial exploitation for this client.
SRM Spoke with the Client on 4/10/2018 and there were other parties present. One of the people with the client was Louise Helder and she
advised she's the Client's neighbor. Per the Client and his neighbor, she assists him by writing checks to pay his bills and that he needs the
$11,000.00 to pay bills. CASE HISTORY American General Life Insurance Company (AGL) issued multiple Individual Retirement Accounts (IRA)
(BB213475 issued 4/7/1994); (BU009259 issued 3/19/1999); (BU204058 issued 2/5/2000); (BU204059 issued 2/28/2000); and (BU204060 issued 2/28
/2000). Total value to date is approximately $38,209.23. December 24, 2014 AGL received a letter from Bergen County; Adult Protective services
(APS) in regards to a... Show more content on Helpwriting.net ...
On 1/6/2017, Client requested to have the surrender reversed and reprocess only $25,000. On March 15, 2018, AGL received a faxed withdrawal
form with instructions to withdraw $30,000; however, it included three account numbers (BU204059, BU204060 and BB213475). AGL sent
communication letter that this could not be processed and a form for each account number will need to be resubmitted. March 19, 2018 AGL
received a letter from Bergen County; Adult Protective services (APS) in regards to a financial investigation concerning our Client. March 22, 2018
AGL received a faxed withdrawal form with instructions to surrender account BB213475 (value $5,786.90) and BU204059 (value $11,153.44). The
process is on hold pending legal investigation. On April 18, 2018 Call received from Agent Mike Irwin regarding his Client and as the representative
begins filling him in on what has been transpiring, he was unaware of the

The Criminal Case Of Dr. Richard Heartman, An Internal...
Health insurance fraud is what drives up health insurance premium costs, wastes taxpayer's money, but can also endanger beneficiaries or leave them
uninsurable. In 2015, Medicare Strike Force reported over $700 million in false billing by doctors, nurses, other licenses medical professionals,
laboratories, and individuals (FBI.gov). This is a staggering figure that is only getting worse. In this fictitious federal case I will be describing the
criminal offender, the crime that was committed, the charge handed down by law enforcement, and the judicial process from the beginning of the
criminal case to the sentencing of Dr. Richard Heartman, an internal medicine physician.
The Defendant
Defendant Richard Heartman, a licensed internal ... Show more content on Helpwriting.net ...
Charges The U.S. Attorney General, or prosecutor Amita Anders, provided the grand jury all the evidence and testimony from witnesses, who voted
to indict Dr. Richard Heartman based on the strong evidence by the U.S. Attorney General, which was able to establish Dr. Heartman was found
guilty beyond a reasonable doubt. On January 31, 2016, FBI agents arrive at his office at Heartless Rd, Heartotack, Illinois and place Dr. Heartman
under arrest. He is read his Miranda rights and has been advised of the charges against him. Because he has been determined to be a flight risk, he will
be detained in the county jail until his arraignment.
Defendant Heartman, has been charged with 10 counts of wire fraud, for knowingly caused to be transmitted by means of wire communication in
interstate commerce from the account of Medicare at Citibank in Indianapolis to the defendants account at JP Morgan Chase in Heartotack, Illinois,
which represents the payments by Medicare on all claims submitted from 2005–2015 by all the individuals. This is a violation of Title 18, United States
Code, Section 1343 (Cornell Law, 2016).
Defendant Heartman also has been charged with 10 counts of U.S. Mail fraud, for knowingly caused to be delivered by United States mail, envelopes
containing checks from commercial and private health insurance carriers, which represented the payments by the

ZZZZ Best Company Fraud: Case Study
ZZZZ Best Company Fraud Case Study
1)At an early age, Barry Minkow was introduced to the carpet cleaning industry by his mother who worked part time as a telephone solicitor for a
small carpet cleaning company. This insight of the industry allowed Minkow to understand that the carpet cleaning industry was one which had very
few barriers to entry, no licensing requirements, and required only a small amount of capital to enter. Also, because of these few barriers to entry, the
industry has historically attracted a larger number of faulty startups in comparison to other industries. At 16 years old, Minkow started his carpet
cleaning company under the name of ZZZZ Best Company. Right away he had a difficult time with customer... Show more content on Helpwriting.net
...
3)There were two external auditors mentioned in the case that dealt with ZZZZ Best. The first was not a firm that was included in the Big Eight
accounting firms at the time. George Greenspan was the sole practitioner who performed the first full–scope independent audit for ZZZZ Best.
Greenspan insisted that he had properly audited Minkow's company, and testified that while planning the audit he had performed various analytical
procedures to identify unusual relationships in ZZZZ Best's financial data. Greenspan's procedures reportedly included comparing ZZZZ Best's key
financial ratios with its industry norms. Greenspan identifies "unusual relationships" but does not go into detail in order to explain these unusual
relationships. This shows that Greenspan did not show enough professional skepticism while conducting the audit and just blew off these unusual
relationships. Also Greenspan testified that he had obtained and reviewed copies of all key documents that pertained to the false insurance restoration
contracts. It would have been hard for Greenspan to uncover the fraud through the contract paperwork because Minkow and Morze went through such
great detail in creating false documents in order to cover the false contracts, but finer details were overlooked by Greenspan. A journalist found one of
these finer details which caused the domino effect leading to the destruction of ZZZZ Best. This shows that the first auditor,

White Collar Crimes Are Committed By Middle Of A Higher...
White collar crimes are committed by middle of a higher status in any given occupation. These crimes often involves a validation of trust from a valued
employee within a company. These crimes can include trade secrets, fraud, money laundering, identity theft, and healthcare fraud. The people
committing these crimes come from a higher class and you wouldn't thinking someone is poor would commit a crime like this in nature. The media
always bring to our attention since the 1990's about the amount of white collar crimes happening in the United States. A few large companies like
Enron, Madoff, Tyco Toys and some other companies were faced with prison sentences for their greed and personal vendettas. The world as a whole
started opening their eyes and seeking knowledge about corporations and private companies to understand the corruption CEO's, lawyer, and trading
companies. White collar crimes are happening more often than in previous years. The media has tried to keep the public aware of the amount of white
collar crimes that are occurring and the justice systems is taking too long to address the problem. Although, white collar crimes are non–violent and
doesn't pose a direct threat like other crimes it still can cause a personal or public perception that is violent in nature. When people lose their life
saving, house, cars, retirement money, and stocks it is hard to say you won't get violent when you know this person has taken everything you own for
their personal gain. Scams

Premera Blue Cross Insurance Fraud
The health insurance company Premera Blue Cross was hacked back in March when 11 million people had their accounts leaked and taken. Six of
the eleven million that had their information stolen were employees and customers of major technology companies like Amazon and Microsoft.
Some of them even work for Star Bucks, all of these people lived in Washington. The other five million were scattered across the United States but
the majority were from Washington. As far as we know the leaked client information hasn't been used for anything. Medical records are highly
valuable because it's not a big top secret file but it can be used for insurance fraud and other ways of taking some ones money. Premera became aware
of the attack and warned the possible

Life Insurance Fraud In The United States
Throughout the semester, we have been studying the many elements of fraud and how it is committed. One of the frauds that are becoming more
common in modern times is life insurance fraud. It takes a certain expertise to commit life insurance fraud because sometimes it usually involves faking
a death. Other times it can involve the actual life insurance company and their premiums. However life insurance fraud is being looked at, it is a fraud
that people and companies are committing more and taking a certain liking too. One of the main reasons for people committing life insurance fraud is
for the money. Life insurance policies can be as low as five–thousand dollars, or be as high one–million dollars or more. To some people, those life
insurance policies amounts can change their lives. In order to collect and cash in on those policies, someone ultimately has to lose their lives. Also for
a life insurance agent, selling a premium so high means higher commission for themselves. Majority of insurance fraud, including life insurance, can be
broken down into two different groups: ... Show more content on Helpwriting.net ...
Straw buyers are people who purchase anything on behalf of someone other than themselves. It is not consider illegal unless it contains fraud. The men
ultimate goal was to let life insurance companies give out bogus insurance policies to unintended policyholders. The men targeted the elderly and
convinced them to apply for these life insurance policies, but never revealed to the insurance companies that these polices were eventually going to be
sold to investors. This fraud resulted in millions of dollars in commission and scammed a few major insurance

Fraud And The Health Care Fraud Essay
On November 21, 2013, Theanna Khou pleaded guilty to dispensing and selling OxyContin from his Huntington Pharmacy without medical necessity
from fraudulent prescriptions issued by a clinic (" Health care fraud investigations," 2014). Khou billed Medicare for filling prescriptions that patients
never received. This story is becoming a norm for the health care industry, because the growing financial prosperity of the health industry. Corruption
and crime is changing, turning from drug dealing to a safer haven that has less legal management, organization, and more wherewithal the business of
health care fraud.
Health Care Fraud Fraudulent misrepresentation (fraud) is defined as the intentional deceit for personal gain (Clarkson, Miller, & Cross, 2012).
Fraud occurs when a person knowingly represents an intentional deception as a fact to gain benefits they are not entitled. The boundaries between
fraud and abuse seem to be confused; the degree of intent distinguishes fraud from abuse. Under HIPAA, it is considered a felony to intentionally
implement a scheme to "defraud any health care benefit program or to obtain money or other property owned or controlled by a health care benefit
program by means of false or fraudulent pretenses, representations, or promises" (Shepard, 2004, para. 1). Health care fraud is an intentional act to
deceive in order to receive greater reimbursement for services, whereas health care abuse is conduct which is not consistent with acceptable

Essay on Managing Financial Resource
There are financial implications for individuals accessing and using services in health care services, Evaluate the impact of these financial implication
on service users. (AC 4.3) The pursuit of equity of access to health care is a central objective of many health care systems. Yet, financial incentives can
influence patients because, although the UK system is essentially 'free at the point of use', there are charges for specific services including eye tests,
dental check–ups, and dispensing of prescription medicines. Charges can act as a deterrent to patients and as a barrier to access. The impact of user
charges affects different socio–economic groups in different ways. For some groups, access may not be compromised by a co–payment,... Show more
The shift in the balance of NHS and private dental care reflects the interests and preferences of dentists rather than of the public. It suggests, however,
that a continued shift towards private practice is a trend that the public will not find acceptable, which might limit the extent of expansion of private
practice. Hughes and McGuire (1995) estimated the impact of charges for drug prescriptions in the NHS and found evidence to suggest that user
charges reduced the number of prescriptions cashed in the UK. However, the impact of user charges is likely to affect different socioeconomic groups
differently. Lundberg et al. (1998) found that price sensitivity decreased with age, income, education and self–rated health status. Furthermore, they
found that sensitivity to user charges for drugs varied greatly between different types of drugs; for example, they found that if user charges doubled
40% of antitussive users would reduce their consumption, whereas only 11% of users of drugs for menopausal problems would reduce their
consumption. It should be recognised that in the UK user charges are means–tested; low–income families and people over 65 years are exempt, as are
individuals with certain chronic conditions, such as diabetes. Some commentators suggested that user charges could (and should) be

Progressive's Ethical Insurance Fraud Case
Joe Lewis and fellow lawyer Jack Green founded Progressive, after they worked on an unethical insurance fraud case. From the beginning, they offered
innovative ideas, as they sought to serve their customers, especially high–risk individuals who could not obtain deals elsewhere. Progressive's main
focus was to become a leader in the automotive insurance industry, and in 2006 they were the third largest company in the automobile insurance
industry. However, as premiums declined in 2005 and 2006, and the market grew stagnant, Progressive had to figure out how to retain and gain market
share. Progressive's stated mission was to reduce the human trauma and economic costs of automobile accidents. STATED AND IMPLIED
OBJECTIVES Profit: Progressive wanted to be positioned at the higher end of the market so that they could maintain their historically high margins on
their products. In order to ensure high–quality products, Progressive wanted to find a balance between maintaining adequate control over their policies
and allowing customers to customize their individual policies. ... Show more content on Helpwriting.net ...
To achieve this objective, Progressive used detailed data to price the high–risk drivers and conduct further research on customers with unfavorable
background records. They had the specific objective of increasing premiums at a rate of at least 15% each year. Citizenship: Progressive attempted to
hire the best and pay the most, and valued creative, resilient employees who could handle stressful situations. They envisioned using their brand to
allow customers to feel safe and cared for, in spite of the intimidating threat of automobile

Ethical Decision Making Ethical Decisions Essay
Having to make an ethical decision regarding unethical circumstances can be challenging for some. "Ethical decision–making refers to the process of
evaluating and choosing among alternatives in a manner consistent with ethical principles. In making ethical decisions, it is necessary to perceive and
eliminate unethical options and select the best ethical alternative.The process of making ethical decisions requires: commitment–the desire to do the
right thing regardless of the cost; consciousness–the awareness to act consistently and apply moral convictions to daily behavior and competency–the
ability to collect and evaluate information, develop alternatives, and foresee potential consequences and risks" (according to Blink, 2016).
The case reading states that there is an employee at Empress Luxury Line by the name of Antonio Melendez who requested a computer system upgrade
who was informed by a technician that he might be getting his request granted due to a shady insurance fraud scam that may be about to take place at
his employment. The technician was informed by his supervisor who received instruction from higher management (CFO) to not only remove some
repairable damaged underground wires connected to the computer system that was caused by a thunderstorm, but to dig up almost all the underground
wire and cable. He was instructed to do so before the insurance adjuster arrives. Of course this makes for the insurance claim to be more than the actual
damage at hand.The

Life &Amp; Health Insurance Fraud

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