Which activity would fall under TDI's Insurance Fraud Unit investigations?

Which activity would fall under TDI's Insurance Fraud Unit investigations?

• A. Selling insurance without a license
• B. Providing customer service
• C. Filing a standard claim without misrepresentation
• D. Underwriting risk

Answer: (A)

The activity being tested is illegal licensing compliance. Selling insurance without a license is exactly the kind of unlicensed, deceptive practice the Insurance Fraud Unit targets, because it bypasses required standards and protections for consumers. The unit looks for actions that undermine the licensing system and could lead to financial harm or fraud, such as selling policies without proper authorization. Providing customer service, filing a standard claim without misrepresentation, and underwriting risk are routine or legitimate insurance activities. They do not by themselves indicate fraud or unlicensed activity, which is why they wouldn’t typically fall under a fraud investigation.

The activity being tested is illegal licensing compliance. Selling insurance without a license is exactly the kind of unlicensed, deceptive practice the Insurance Fraud Unit targets, because it bypasses required standards and protections for consumers. The unit looks for actions that undermine the licensing system and could lead to financial harm or fraud, such as selling policies without proper authorization.

Providing customer service, filing a standard claim without misrepresentation, and underwriting risk are routine or legitimate insurance activities. They do not by themselves indicate fraud or unlicensed activity, which is why they wouldn’t typically fall under a fraud investigation.