Health insurance fraud presents a multidimensional problem impacting many stakeholders that include patients, businesses, taxpayers, premium payers and public and private health insurance providers. With specific reference to health insurance providers, health insurance frauds not only lower earnings in the insurance business, leading to substantial losses, but also impact their pricing strategy and socio-economic contributions of the insurance sector. Health insurance is highly vulnerable to frauds due to the high volume of claims, largely manual verification of claims and potential collusion among beneficiaries, hospitals, as well as employees of insurance companies. Health insurance frauds not only result in depletion of financial resources making them unavailable when needed, but also increases health insurance costs. It is therefore imperative that health insurance frauds ought to be fought using specialized fraud management systems. In this chapter, we attempt to present a holistic approach, beginning with basics of frauds; finer shades of difference between fraud, abuse and waste; voluntary and mandatory health insurance and the nature and challenges associated with frauds in both segments; identification of fraud and its mitigation with focus on prevention, detection, and deterrence strategies; and finally use of modern techniques of fraud detection using artificial intelligence. As India has taken steps towards Universal Health Coverage in line with Sustainable Development Goals through publicly financed health insurance, its implementation policy across India’s diverse states has paved the way for a pivotal role of private insurers as well. However, frauds in the system and leakages will invariably influence actuarial strategies. Frauds also cause a dent in the allocative and technical efficiencies in the health system, thus impacting progress towards Universal Health Coverage.