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Health insurance fraud is described as an planned act of misleading, concealing, or misrepresenting information that results in health care benefits being paid to health insurance policy holder.

Both a policyholder and a health insurance provider can commit fraud. Policyholder fraud consists of disallowed members and/or dependents, alterations on enrolment forms, concealing pre-existing conditions, failure to report other coverage, prescription drug fraud, and failure to disclose claims that were a result of a work related injury. Provider fraud consists of claims submitted by bogus physicians, billing for services not rendered, billing for higher level of services, diagnosis or treatments that are outside the scope of practice, alterations on claims submissions, and providing services while under suspension or when license have been revoked. Independent medical examinations are used to debunk false insurance claims and allow the insurance company or claimant to seek a non-partial medical view for injury related cases.

Details here: http://en.wikipedia.org/wiki/False_insurance_claims

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I have finally received the hard copy of my cheque which was issued to Max
New York Life Insurance and it is clearly visible that the date has been
tampered with.

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Even a novice in the business can make out that the date on my cheque has
been changed/modified from 2.09.09 to 2.08.09. I would request you to kindly
help me out with further proceedings as this is a clear cut case of Fraud by
both these so called highly reputed MNC's.

How could HDFC officials accept and bounce a cheque with clear modification
in date! The reason for bouncing the cheque was "INSUFFICIENT FUNDS"!

On the other hand Max New York Life Ltd has tampered with my cheque
instrument which is a clear cut case of fraud and cheating!

I would request you to kindly help me out as this has been going on since
30th Aug and all this is causing a lot of mental depression to me.

Seek your help on the issue sir.


Sincere Regards

Adarsh Sharma
9311525279

reply here: http://www.consumercourt.in/life-insurance/10216-complaint-against-max-new-york-life-insurance.html#post18347

ICICI prudential, Malleswaram, Bangalore received a cheque from me on Jan 6 2007 as a payment towards a life insurance policy. On jan 14 2008 when i went to pay the premium for the current year, i was said that i need to pay for the year 2007.

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On specifying that i had made payment for 2207 using a cheque drawn on ICICI bank, they were of the opinion that the cheque bounced. I checked with the bank only to know that the cheque leaf is unused.

Then i reverted to ICICI prudential again only to be said that the cheque was postdated which wasn’t the case. They knew that and also as a policy they didn’t accept post dated cheques.

when i said that since the mistake was at there end they need to give me back dated NAV for which they promptly disagreed and said that i need to make a payment for two years else the policy will continue to be in lapse state.

They gave a crap about how i should have checked my bank balance to see that the payment want made and that they had sent a mail to that respect, which of course I dint receive and nor do they have a proof of the same. They didn’t let me speak to the manger either because they did not want the manger to know the goof up or the manager dint want to take responsibility. Whenever I try to reach the manger on phone I am told that either she is busy or not in office.

All this has left a bitter taste on dealing with ICICI group as such, because of their callous and indifferent nature. They should stop priding themselves has being a customer friendly group.
Reply here: http://www.consumercomplaints.in/complaints/icici-prudential-life-insurance-c31773.html