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Insurance Fraud

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Everything You Need to Know About Insurance Fraud

Insurance fraud is the intentional deception of an insurer, in which the fraudster aims to gain an unjustified advantage for themselves. Insurance fraud comes in various forms. Not everyone who commits insurance fraud sees themselves as a fraudster. After all, what’s the big deal if you report an extra cell phone to the insurer after your home has been burglarized? Or if you claim a few old dents when having your car repaired? Yet these are all forms of insurance fraud.

Insurance companies take insurance fraud very seriously. They invest a great deal of time in identifying and investigating it. If you’re caught committing insurance fraud, it can have serious consequences. For example, you’ll have to pay a standard fine, and the matter may be reported to the police. In addition, it will be more difficult for you to obtain insurance in the future.

Examples of Insurance Fraud

According to the DutchAssociation of Insurers, the most common types of insurance fraud involveauto insurance,home contents insurance, andliability insurance. Every year, insurers deal with thousands of fraudulent claims or insurance applications containing false information. Of course, we’ve already given a fewexamples of insurance fraudabove, but there are countless others. For example, people might lie about the contents of their suitcase if they lose it while on vacation. Or they might report a very expensive camera that they may not have even brought along in the first place. People also regularly download photos of damage from the internet to use in filing a false claim.

Report Insurance Fraud

Do you suspect insurance fraud? If so, you can reportit (anonymously, if you wish) to theCenter for Combating Insurance Crime (CBV) of the Dutch Association of Insurers. The CBV helps insurers combat insurance crime. You can file a report at cbv@verzekeraars.nlor call 070-333 85 00.

Penalty for Insurance Fraud

There are specificpenaltiesfor committing insurance fraud. For example, since 2016,SODAhas been imposing a standard fine of €532. SODA stands for Service Organization for Direct Liability. In addition, insurers can recover the costs incurred in investigating the fraud from the fraudster. In some cases, a report will also be filed with the police. Insurers do this particularly when the amount of fraud is very high or when organized crime is involved.

Insurance Fraud Investigation

Does the insurer suspect fraud? If so, they must, of course, be able to prove it. That is why they always conductan investigationwhen fraud is suspected.Theseinvestigation costs can add up significantly, especially if an external investigative firm or expert needs to be hired. If it turns out that fraud was indeed committed, these investigation costs will be recovered from the fraudster. After all, if there had been no fraud, no investigation would have been necessary, and these costs would not have been incurred. That is why any investigation costs are always borne by the fraudster.

Consequences of Insurance Fraud

If you’re caught committing insurance fraud, this can have serious consequences. For example, the insurer will not pay out any compensation for the damage if it turns out that you committed fraud. Did you, for instance, stage a burglary? Then you’ll have to cover all those costs yourself. In addition, the insurer has the right to cancel your insurance policy immediately. This means you will no longer be insured. Furthermore, you will be registered as a fraudster in the CIS Foundation’s database . Your information will then be visible to all affiliated insurers. With a CIS registration, it becomes much more difficult to obtain new insurance. Moreover, you will likely end up paying significantly more for your insurance.

Statute of Limitations for Insurance Fraud

Insurance fraud is not taken lightly by insurers. Individuals who have committed fraud pose a significant risk to insurance companies. As a result, a report of insurance fraud remains on record longer than any other type of report. Thestatute of limitationsfor insurance fraud is approximately 8 years. During these 8 years, this report is visible to every affiliated insurer.

Challenging Insurance Fraud

Are you suspected of insurance fraud? If so, this could have serious consequences. We’re not just talking about financial consequences, but also about being registered as a fraudster. This will significantly impact your current and future insurance policies. In some cases, the insurer may decide to report the fraud to the authorities, which can lead to criminal penalties. A record of fraud does not simply disappear from the system. If you believe the record is unjustified, you can challenge it. If you are suspected of insurance fraud, it is sometimes wise to hire a lawyer right away.

Auto Insurance Fraud

Car insurancefraud is one of the most common forms of insurance fraud. For example, someone might report theircar as stolen when it’s actually just sitting in the garage. Or someone might quickly adjust their car insurance coverage and then file a claim so that the damage is covered and reimbursed. There are countless examples of this type of auto insurance fraud. If you’re caught committing auto insurance fraud, it will be difficult to obtain new auto insurance in the future.

Insurance Fraud Reporting

To warn other insurers, your personal information will always be recorded if you are caught committing insurance fraud. You will then be registered with Stichting CIS. CIS stands for Central Information System. When reviewing an insurance application, an insurer will always check the CIS Foundation’s database to see if you are registered and, if so, why. Are you registered for insurance fraud? If so, there’s a good chance the insurer will reject your application. You’re considered too high a risk.

Types of Insurance Fraud

There are various types of insurance fraud. You can commit insurance fraud before entering into an insurance contract, for example, by providing false information to the insurer. You can also commit insurance fraud after taking out the insurance policy. Here are a few examples:

Lying or Concealing Information When Applying for Insurance

Insurance fraud when applying for insurance occurs regularly. Someone provides false information to increase the likelihood of approval. Before an insurer approves an insurance application, it always asks a number of underwriting questions. Examples of underwriting questions include:

  • Have you ever had your driver's license suspended?
  • Has your insurance policy ever been canceled or declined by another insurer?
  • Have you had any contact with the police or the judicial system as a suspect in the past eight years?

If any of these questions apply to you, you must always answer “Yes.” If you do not answer the questions truthfully, you are committing insurance fraud.

Intentionally causing damage

It’s not uncommon for someone to intentionally cause damage in order to collect insurance benefits. For example, by staging a collision or a crash, or by deliberately driving into something. It’s then up to the insurers to prove that it’s actually a case of fraud. That’s why a specialist always comes by to assess the situation. There are always a few details that people overlook when committing insurance fraud. For instance, they fail to realize that a window must be smashed from the outside, so they do it from the inside instead. This makes it easy for an insurer to quickly realize that fraud has been committed.

Claiming more damages than were actually incurred

This is one of the most common types of insurance fraud. Some people can’t resist listing a few extra items when filing a claim—items that really shouldn’t be included at all. For example, they might claim an extra phone after a burglary. Or they might claim a few old dents in their car after a collision or a parking accident. They exaggerate the actual damage or the number of items stolen so they can receive a higher payout from their insurer.

Pretending that damage has been suffered or distorting the facts

Insurers regularly encounter situations where people pretend that a loss has occurred, when in fact it has not. They do this, for example, by reporting a laptop as stolen when they have actually lost it themselves. Or they resubmit a claim that was previously denied, but with a different story so that it falls within the scope of the insurance coverage. They distort the facts so that the insurer is forced to pay out a claim.

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Frequently Asked Questions About Insurance Fraud

What exactly is insurance fraud?

Insurance fraud is the intentional deception of an insurer, with the fraudster aiming to gain an unjustified advantage for themselves. According to theDutch Association of Insurers, the most common types of insurance fraud involveauto insurance,home contents insurance, andliability insurance.

How Does Insurance Fraud Work?

There are various types of insurance fraud. Here are a few examples:

  • Insurance Fraud When Applying for Insurance

When applying for insurance, someone provides false information. An insurer always asks a number of underwriting questions before accepting an insurance application. For example, they ask whether your insurance has ever been canceled or declined by an insurer, whether you’ve ever hadyour driver’s license revoked, and whether you have a criminal record. If any of these apply, you must always answer “Yes” to these questions. If you do not answer the questions truthfully, you are committing insurance fraud.

  • Claiming more damages than were actually incurred

When reporting a claim, someone provides false information. For example, after a burglary, they may list more items than were actually stolen. They exaggerate the actual damage or the number of items stolen in order to receive a higher payout from their insurer.

  • Falsely claiming that damage has been suffered or distorting the facts

For example, by reporting a lost laptop as stolen. The facts surrounding the damage are also regularly distorted so that it falls within the scope of the insurance coverage.

  • Intentionally causing damage

Insurers regularly encounter cases where someone stages a collision or deliberately drives into something. It’s then up to the insurers to prove that it’s actually a case of fraud. A specialist always comes by to investigate the matter. That’s how they quickly discover if, for example, you’ve smashed a window in your own home to stage a break-in. Especially if you break the window from the inside, as is often the case.

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