Insurance fraud
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All about insurance fraud
Insurance fraud is the intentional deception of an insurer, where the fraudster's goal is to unfairly benefit himself. Insurance fraud comes in different degrees. Not all people who commit insurance fraud see themselves as fraudsters. After all, what difference does it make if you declare an extra cell phone to the insurer after the house has been broken into? Or if you also claim a few old dents when repairing a car? 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 are caught committing insurance fraud, this can have serious consequences. For example, you will 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 Association of Insurers, most fraud occurs with car insurance, household insurance and liability insurance. Insurers face thousands of false claims or applications for insurance with incorrect information every year. Of course, we've already given some examples of insurance fraud above, but there are countless more to think of. For example, people lie about the contents of their suitcase when they lose it on vacation. Or they give up a very expensive camera they may not have had with them at all. People also regularly take damage photos off the Internet to file 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 [email protected]or call 070-333 85 00.
Insurance fraud penalty
Committing insurance fraud does carry certain penalties. For example, since 2016, SODA has been demanding a standard fine of €532. SODA stands for Service Organization Direct Liability. In addition, insurers can recover the costs incurred in investigating the fraud from the fraudster. Reports will also be filed with the police in some cases. Insurers do this particularly if the fraud amount is very high or if organized crime is involved.
Insurance fraud investigation
Does the insurer suspect fraud? Then of course they have to be able to prove it. Therefore, if they suspect fraud, they will always conduct an investigation These investigation costs can be substantial, especially if an external investigation agency or expert has to be hired. If it turns out that fraud has indeed been committed, these investigation costs will be recovered from the fraudster. If there had been no fraud, no investigation would have had to be started and these costs would not have been incurred. Therefore, any investigation costs are always borne by the fraudster.
Insurance fraud implications
If you are 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 have committed fraud. Did you, for instance, stage a burglary? Then you will have to cover all those costs yourself. In addition, the insurer has the right to cancel your insurance immediately. You will then no longer be insured. Furthermore, you will be registered as a fraudster in the CIS Foundation 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.
Insurance fraud statute of limitations
Insurance fraud is not taken lightly by an insurer. Individuals who have committed fraud pose a great risk to insurance companies. Consequently, a report for insurance fraud stays on the record the longest of all reports. The statute of limitations for insurance fraud is about 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 can 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 immediately hire a lawyer.
Insurance fraud car
Car insurancefraud is one of the most common forms of insurance fraud. For example, someone might report theircar as stolen when it’s actually sitting in the garage. Or someone might quickly adjust their car insurance coverage and then file a claim for the damage, so that the damage is covered and reimbursed. There are countless examples of car insurance fraud like this. If you’re caught committing car insurance fraud, it will be difficult to get new car insurance in the future.
Insurance fraud registration
To warn other insurers, your personal information will always be recorded if you are caught committing insurance fraud. You will then be registered with the CIS Foundation. CIS stands for Central Information System. When assessing an insurance application, an insurer will always check the Stichting CIS database to see if you are registered and why. Are you registered for insurance fraud? Then there is a good chance that the insurer will reject your application. You are then 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. Here are a few examples:
Lying or concealing when applying for insurance
Insurance fraud when applying for insurance is common. Someone provides false information to increase the chances of acceptance. Before an insurer accepts an insurance application, it always asks a number of acceptance questions. Acceptance 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 is common for someone to intentionally cause damage in order to receive benefits. For example, by staging a collision or anywhere, or by deliberately driving into something. It is then up to insurers to prove that it really is fraud. This is why a specialist always comes in to look at the case. There are always some things people overlook when committing insurance fraud. For example, it is not considered that a window has to be smashed from the outside and it is done from the inside. Thus, an insurer quickly realizes that fraud has been committed.
Claiming more damages than actually suffered
This is one of the most common types of insurance fraud. Some people can't resist or declare some extra items when claiming damages that really shouldn't be claimed at all. For example, giving up an extra phone after a burglary. Or claiming a few old dents in the car after a collision or parking accident. They exaggerate the actual damage or the number of items stolen so that they will be reimbursed more by their insurer.
Pretending injury or distorting the facts
Insurers frequently experience people pretending to have suffered damage when this is not the case at all. They do this by, for example, reporting a laptop as stolen while they themselves have lost it. Or they submit a rejected claim again, but with a different story so that it does fall within the insurance coverage. They twist the facts so that the insurer has to pay compensation.
Frequently asked questions about insurance fraud
What exactly is insurance fraud?
Insurance fraud is the intentional misleading of an insurer, where the fraudster's goal is to unfairly benefit himself. According to the Association of Insurers, most fraud occurs with auto insurance, household insurance and liability insurance.
How does insurance fraud work?
There are several types of insurance fraud. We list some examples here:
- 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 have ever hadyour driver’s license revoked, and whether you have a criminal record. If this is the case, you must always answer these questions with “Yes.” If you do not answer the questions truthfully, you are committing insurance fraud.
- Claiming more damages than actually suffered
When reporting damages, a person reports incorrect facts. For example, after a burglary, they report more items than were actually stolen. They exaggerate the actual damage or the number of items stolen so they will be reimbursed more by their insurance company.
- Pretending injury or distorting facts
For example, by reporting a lost laptop as stolen. They also frequently twist the facts of the claim so that it falls within the insurance coverage.
- Intentionally causing damage
Insurers regularly encounter cases where someone stages a collision or deliberately crashes into something. It is then up to the insurers to prove that it is indeed a case of fraud. A specialist always comes by to assess the situation. This allows them to quickly detect if, for example, you have smashed a window in your home yourself to stage a burglary. Especially if you break the window from the inside, as is often the case.
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