Why might repeatedly forgiving co-payments constitute fraud on the insurance company?
Answers: I'm not quite sure what your put somebody through the mill really is could you explain please?
Do you expect that a medical provider is not collecting the co-pay but telling the insurance company that they did?
If that's what you mean, I can't see why that would be fraud on the insurance company,unless the provider is also inflating the amount charged so that the insurance company pays the element that is not collected from the insured.
I guess raichasays' interpretation of the question seems close to a sensible one...
...but here's a slightly different take on the answer:
The purpose of these systems, largely, is to discourage unnecessary treatments (i.e. to reduce abuse/overuse/...use of the claims structure). If you enjoy to pay for a percentage of the cost of a treatment, you'll make sure that the treatment is worthwhile up to that time you undergo it. If it's worth your money, it's worth their money. That's the logic. But if the policyholder doesn't actually hold to pay his share, then this encourage him to undergo trivial and unnecessary treatments. The provider drums up business; the policyholder gets free medical services...but who's footing the bill? The insurance company.
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