Which of the following would be classified as internal insurance fraud?

The classification of internal insurance fraud typically involves actions taken by individuals within an organization, such as employees, that exploit their position and trust to commit fraudulent acts against the company.

Claiming for an inflated medical bill fits within this definition, as it involves manipulating the billing process to misrepresent the cost of services provided, potentially benefitting an employee who is part of the insurance system. This action could involve collusion between healthcare providers and employees to illegally maximize payouts from the insurance company.

In contrast, filing a false claim for stolen property more typically characterizes external fraud perpetrated by policyholders rather than internal manipulation. Providing counterfeit documentation for a policy also leans toward external activities, often driven by individuals outside the company. Engaging in premium fraud, while it may seem internal, is more about avoiding the correct reporting of income, which could fall under external attempts to deceive the insurance system without direct manipulation from within. Thus, the act of inflating medical bills by someone within the insurance process clearly represents an internal fraud scenario.