Elizabeth’s workers' compensation fraud is classified as which type of fraud?

• A. Premium fraud
• B. Claimant fraud
• C. Agent fraud
• D. Organized fraud

Answer: (B)

In workers' compensation, fraud is understood by who commits the misconduct. When the person filing the claim misrepresents facts to obtain or increase benefits, this is claimant fraud. This includes exaggerating the injury, claiming benefits for injuries not present, or making false statements on the claim form. Elizabeth’s case fits this type because the fraudulent act comes from the claimant seeking benefits, not from an employer evading premiums, a misleading agent, or a coordinated criminal scheme. Premium fraud would involve underreporting payroll or avoiding premium payments; agent fraud involves a deceitful person who handles the policy; organized fraud implies a coordinated network. So the situation described aligns with claimant fraud.