Tseng, Lu-Ming; Kang, Yue-Min - In: The Geneva Papers on Risk and Insurance - Issues and … 40 (2015) 2, pp. 334-352
Although it is acknowledged that the final decision of whether to accept or reject a medical claim application is determined by medical insurance claims adjusters, very little research on insurance fraud has considered the factors that contribute to the unjustified claim decisions made by these...