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Health Insurance Scams – Common Cyber Attacks

Written by Anuraag Singh ~ Modified: 16-08-2023 ~ Cyber Awareness ~ 5 Minutes Reading

These days the health insurance market is growing. As a result, users are facing “ Health Insurance Scams”. Due to the increase in fraudulent activities, the health sectors in India are facing monetary loss. Insurance Fraud is a crime that has an impact on both policyholders and as well as customers. If you are one of them, who is facing such problems, then this article is for you.

Firstly, let’s shed light on what this fraud is all about…

What are Health Insurance Scams?

Con artists are becoming more creative. Nearly every day, new strategies for scamming insurance firms are employed. One of the most common ways to defraud an insurance provider is to get an insurance policy in the name of a person who is terminally sick. Doctors that check for pre-existing conditions in patients are offered money or blackmailed with forging reports. 

For instance, if a patient is given a cancer diagnosis, the doctor will write a note approving the necessity of an insurance claim reimbursement for that specific patient. The insurance claim sum is then given to the fraudster when the patient passes away from cancer. Rural India has a limited understanding of technology, making it easy to plan these kinds of health insurance scams there in order to obtain health. 

Cybercriminals also use different ways in this scam to lure people. Let’s cover this in our next section. 

Different Types of This Fraud

There are many additional forms of this fraud. To understand more about the various ways, continue reading.

1. Claim Fraud: The most typical kind of health insurance fraud is claim fraud. It happens when a policyholder files false medical invoices or overstates the costs associated with their medical care. In some of the revealed medical insurance fraud cases, the policyholders themselves fabricated medical invoices in order to collect the money guaranteed.

2. Application Fraud: It refers to the policyholder omitting information or lying about specifics that must be revealed at the time the insurance is purchased. These might include specifics like pre-existing conditions or lifestyle decisions, the revelation of which would increase the premium. 

3. Eligibility Fraud: When a policyholder file claims for diseases or treatments that are not covered by their coverage, eligibility fraud may take place. 

It’s crucial to remember that eligibility fraud might occur without the policyholder’s knowledge. This is why it’s essential to study the small print in health insurance contracts and become familiar with your policy’s benefits and restrictions.

Five Signs of Health Insurance Scams

There are several Medicare and health insurance frauds. Scammers utilize tried-and-true methods even though they are constantly seeking new ways to steal your money and personal information. Here are five indications that health insurance fraud is at play:

1. Scammers pose as government representatives and demand money or personal data. Government organizations never ask for personal or financial information. If someone asks then it is a scam.

2. Fraudsters claim that you have to pay a charge for a new medical health insurance card. 

3. You may be offered a bogus medical discount plan by con artists. Fraudsters may ask for the monthly fee for the medical discount program. As a result, they do not serve as a replacement for health insurance. While some medical discount programs offer honest savings, others simply steal peoples’ money and give them nothing in return. And before you join up, receive the discount plan’s specifics in writing.

4. In return for a price estimate, con artists seek access to your private information. HealthCare.gov is the official government website for the Affordable Care Act (ACA). You may use it to compare health insurance plan costs, determine your eligibility for healthcare subsidies, and start the enrollment process. However, HealthCare.gov just asks for your age and monthly income to provide a pricing estimate. Never provide personal financial details for a health insurance quotation, such as your Social Security, bank account, or credit card number. You’ll be inviting robocalls or, even worse, identity theft.

5. Scammers demand payment in exchange for assistance with the Health Insurance Marketplace. The individuals who really assist you with the Health Insurance Marketplace, commonly referred to as Navigators or Assisters, are not permitted to charge you and will not request any of your personal or financial information. Click “Find Local Help” on HealthCare.gov to find out more.

How to Prevent These Health Insurance Scams?

The insurance industry in India has suffered significant losses as a result of numerous scams. Additionally, the firm and other genuine policyholders are harmed by the fraud committed by the policyholder or company personnel, which is illegal. Here are some recommendations for preventing insurance fraud in India:

  1. It is crucial to spot fraud when filing a claim in order to cancel the insurance and maybe put the offending party in jail.
  2. To avoid health insurance scams. Be careful while giving your personal information to anyone.
  3. To make sure you’re buying from a trusted source, choose to acquire the coverage straight from the insurance provider. 
  4. In addition, buying a policy online might save you money because there is no middleman involved and you receive the insurance in your mailbox, where you can access it whenever you want.


Insurance providers are making every effort to halt the damaging impacts of extortion. The fight against health insurance scams, however, can only become better with every innovation in technology. Instead of policyholders losing faith in the insurance industry owing to widespread insurance fraud, insurers may restore their credibility by conducting adequate safety inspections.