Insurance Fraud
Insurance fraud is the intentional deception of an insurer in order to receive an unjustified payout or to obtain a premium discount. It occurs in connection with both claims and the purchase of insurance policies. There are various types of insurance fraud, and the penalties are severe.
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What is insurance fraud?
Insurance fraud is the intentional deception of an insurer for personal gain. Every year, thousands of insurance applications are submitted with false information, and many claims are filed unjustifiably. Not everyone who commits fraud sees themselves as a fraudster.
Examples of Insurance Fraud
Reporting additional stolen items to your insurance company after a break-in.
Lie about the contents of your suitcase if you lose your luggage.
Claiming for Previous Damage When Repairing a Damaged Car.
In addition, people often search the internet for photos of damage or use AI tools like ChatGPT to generate a photo or invoice, which they then use to file false claims. The insurer’s claims adjusters always see right through this.
4 Types of Insurance Fraud
There are various forms of insurance fraud.
1. Withholding Information When Applying for Insurance
Are you applying for a new insurance policy? If so, the insurer will ask you a few questions before accepting your application. If you do not answer these questions honestly, it constitutes insurance fraud. For example:
- Has an insurance company ever rejected your application?
- Has your insurance ever been canceled?
- Do you have a criminal record?
- Has your driver's license ever been suspended?
2. Claiming more than the actual damages suffered
It is also fraud to provide false information when reporting a claim. For example, if you list more items as stolen in a burglary than were actually taken. In that case, you are providing false information and exaggerating the loss so that the insurer will pay more. This is not allowed.
3. Distorting facts and making false claims
Another form of fraud is filing false claims. For example, if you claim your phone was stolen when you actually lost it yourself. Altering the facts so that the insurance company will pay for your loss is fraud.
4. Intentionally causing damage
It often happens that people deliberately cause an accident or drive into something in order to collect money. The insurer must then prove that this is fraud. To do so, the insurer calls in a specialist.
This person can immediately tell whether a break-in is real or not, and whether someone broke a window themselves. Sometimes, the window is broken from the inside rather than from the outside.
Consequences of Insurance Fraud
Insurers take insurance fraud very seriously and devote a great deal of time to identifying, detecting, and addressing it.
If you're caught committing fraud, it could have serious consequences:
You won't receive any compensation and will have to cover the costs yourself.
You must pay a fine. Since 2016, you have been required to pay a minimum fine of 532 euros to the Direct Liability Service Organization (SODA).
You must pay for any examination costs.
The insurer files a report with the police.
The insurance company will cancel your policy immediately.
You will be listed as a fraudster in the CIS Foundation's database. The information in this database is visible to all participating insurers. This makes it difficult to obtain new insurance.
You'll pay a higher premium on your next insurance policy.
Insurance Policies Prone to Fraud
The Dutch Association of Insurers showed that the following types of insurance are most commonly subject to fraud:
Challenging Insurance Fraud
If you are suspected of insurance fraud, it can have serious consequences. Do you believe the report is unfounded? If so, you can file an objection. It is wise to consult a lawyer for this.
Statute of Limitations for Insurance Fraud
Insurance fraud results in high costs for insurers. For this reason, a report of insurance fraud remains on record longer than other reports. The report remains visible for approximately 8 years. During this period, all affiliated insurance companies can view the report.
Insurance Options After Fraud
Have you committed insurance fraud? If so, you will no longer be able to get insurance from a regular insurer. De Vereende is one of the few insurers that will likely accept you. However, you’ll have to pay a high premium.
Report Insurance Fraud
Do you suspect insurance fraud? If so, file an (anonymous) report with the Center for Combating Insurance Crime (CBV). This organization helps insurers prevent and investigate fraud and is part of the Dutch Association of Insurers.
You can easily submit a report via the website, send an email to cbv@verzekeraars.nl, or call 070-333 85 00.
Frequently Asked Questions About Insurance Fraud
How is insurance fraud detected?
Insurers use advanced systems and specially trained fraud investigators to analyze suspicious claims. They look for unusual damage patterns and inconsistencies in statements, and sometimes use outside experts or databases such as Stichting CIS to detect fraud.
What are the penalties for insurance fraud?
Anyone caught committing insurance fraud will not receive compensation and may be fined at least €532. In addition, insurers may file a report with the police, terminate the insurance policy, and recover the costs of the investigation. This usually results in an entry in the CIS registry as well.
How long do you remain registered as a fraudster?
In most cases, a record of insurance fraud in the CIS Foundation’s database remains visible for eight years. During this period, other insurers can view the report, which may affect a person’s ability to obtain new insurance policies.
What are the consequences of CIS registration?
A CIS record as a fraudster makes it difficult to obtain insurance from mainstream providers. In addition, you’ll often have to pay a higher premium, and your application may be denied. Coverage for existing insurance policies may also be adjusted or terminated.
What are some examples of insurance fraud?
Examples include: reporting additional items after a burglary, re-filing a claim for old damage, filing a false report of theft, or intentionally causing damage. Concealing a criminal history when applying for insurance also constitutes fraud.
Can you still get insurance after committing fraud?
Yes, but not with regular insurers. De Vereende is one of the few insurers that will likely accept you. You will, however, have to pay a high premium.
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