How is insurance fraud investigated?

The number of reported cases of insurance fraud is rising rapidly. Recently, a record number of insurance fraud cases was even recorded. However, there is a difference between the number of fraud investigations and the number of confirmed fraud cases. After all, an insurer must be able to prove that fraud has actually occurred. That is why they always launch an investigation when insurance fraud is suspected. Here, we explain how insurance fraud is investigated.

When does an insurer investigate insurance fraud?

Are you filing an insurance claim? If so, the insurer may investigate whether the claim is legitimate. Claims are often reviewed by an automated system. For example, there is a specific threshold amount above which a review may be conducted automatically. For car damage, for example, this is €1,000, and for a bicycle, it’s €500. There are also a number of red flags that are automatically flagged. For example, if you file a claim for the same type of damage within a short period of time. Or if you’ve changed your insurance coverage and file a claim immediately afterward. These are all reasons for an insurer to launch an investigation.

In addition, when an insurance application is submitted, the insurer always verifies the applicant’s identity. If there is reason to believe that something is not quite right with the information provided, the insurer may launch an investigation. After all, insurance fraud also includes failing to provide truthful information when applying for insurance.