Report insurance fraud

(0800 372 835)

Insurance fraud adds to the cost of insurance premiums. It is an inevitable cost of the business of insurance; it has to be paid for by honest policyholders. International research shows that the higher the cost of insurance, the lower the uptake of insurance is. I.E. fewer people can afford it. If insurers can reduce the amount of fraud through efficient policing of claims, the cost of insurance will be lower and more people will be able to afford to insure.

Some of the things that insurers are doing to reduce the amount of fraud include;

• Specialist claims training - all insurance claims personnel have fraud detection training. Insurance companies have list fraud indicators and if claims include 1 or more of these fraud indicators they are referred to specialist claims teams, or investigators for closer review. Some claim specialists have an innate ability to spot fraud and can refer cases for further investigation just on a hunch.
• Specialist investigators - insurers have teams of specialist claims investigators who are mainly ex-police. These personnel undergo insurance training and fraud detection training. They are the front line of fraud detection sector of the industry.
  Just because claims are referred to investigators, does not necessarily mean that there is fraud involved. Often claims are referred for further clarification of the circumstances of a loss.
• Insurance Claims Register - the insurance industry has a register of insurance claims, which is used to check whether full disclosure of claims history has been made and whether claims for the same loss are being made on more than 1 insurer. The ICR has been operating for 10 years and has over 6 million claims in the database. Some companies check the ICR when policies are taken out to ensure they have been given correct information and that the policy premium has been set at the correct level that reflects the risk.
• Zero tolerance of insurance fraud - insurance companies will prosecute fraudsters through the courts when they have clear evidence that a claim is fraudulent. The insurance industry has a Memorandum of Understanding with the Police, which sets out procedures for the prosecution process.
• Specialist fire investigators - arson is a major problem in insurance claims and for almost all large fires, insurers appoint specialist fire investigators to check for suspicious circumstances that might indicate fraud.
• Fraud hotline - the Insurance Council has a 0800 number (0800 fraud line [372835]), where the public is encouraged to call and leave information about potential insurance fraud cases. This information can be made anonymously and no details are passed to the alleged fraudster.

Insurance fraud is often portrayed as a victimless crime, but nothing can be further from the truth. When a fraudulent claim is made, all policyholders bear the cost.

Help the insurance industry stamp out fraud!!

 

 

 

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