Insurance fraud
Insurance fraud is the intentional deception of an insurer in order to receive unjustified payments or gain premium advantage. It occurs in both claims and insurance underwriting. There are different types of insurance fraud and the penalties are severe.
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What is insurance fraud?
Insurance fraud is the intentional misleading of an insurer to benefit oneself. Every year, thousands of insurance policies are applied for with false information and many claims are wrongly made. By no means everyone who commits fraud considers themselves a fraudster.
Examples of insurance fraud
Report extra stolen items to insurance after a burglary.
Lying about the contents of your suitcase when you lose luggage.
Old damage claim when repairing a damaged car.
In addition, people often look up photos of damage on the Internet or have AI tools such as ChatGPT take a photo or invoice and submit false claims. Insurance claims adjusters always figure this out.
4 types of insurance fraud
There are various forms of insurance fraud.
1. Withholding information on your insurance application
Are you applying for new insurance? Then an insurer will ask you a few questions before accepting the insurance application. If you do not answer these questions honestly, it is insurance fraud. For example:
- Has an insurer ever denied your application?
- Has your insurance ever been discontinued?
- Do you have a criminal history?
- Has there ever been a driving disqualification?
2. Claiming more than the actual damages suffered
It is also fraud if you give false information when reporting damage. For example, if you report more items in a burglary than were actually stolen. You then give incorrect information and make the damage bigger so that the insurer pays more. This is not allowed.
3. Distorting facts and making false claims
Another type of fraud is filing bogus claims. For example, saying your phone was stolen when you actually lost it yourself. Changing facts so that the insurance company pays your claim is fraud.
4. Deliberate harm
It often happens that people intentionally cause an accident or drive into something to get money. The insurer then has to prove that this is fraud. To do this, the insurer engages a specialist.
This person can immediately tell if a burglary is real or not and if someone has smashed a window themselves. This is because sometimes the window is broken from the inside rather than the outside.
Consequences of insurance fraud
Insurers take insurance fraud very seriously and spend a lot of time recognizing, detecting and fixing it.
Are you caught cheating? If so, there could be serious consequences:
You will not receive compensation and must cough up the costs yourself.
You have to pay a fine. Since 2016, you pay a minimum fine of 532 euros to Service Organization Direct Liability (SODA).
You must pay any investigation fees.
The insurer files a police report.
The insurance company will cancel your insurance immediately.
You will be registered in the database of the CIS Foundation as a fraudster. The data in this database are visible to all affiliated insurers. This makes taking out new insurance difficult.
You pay a higher premium on subsequent insurance.
Fraud-prone insurance
The Association of Insurers showed that most fraud is committed with the following insurance policies:
Challenging insurance fraud
If you are suspected of insurance fraud, the consequences can be dire. Do you think the registration is unjustified? If so, you can appeal this. It is wise to hire a lawyer to do this.
Insurance fraud statute of limitations
Insurance fraud creates high costs for insurers. Therefore, a report of insurance fraud remains longer than other reports. The report remains visible for about 8 years. During this period, all affiliated insurance companies can see the report.
Insurance options after fraud
Have you committed insurance fraud? Then you can no longer turn to a regular insurer. De Vereende is one of the few insurers you can probably turn to. However, you pay a high premium.
Report insurance fraud
Do you think there is insurance fraud? Then make an (anonymous) report to the Centrum Bestrijding Verzekeringscriminaliteit (CBV). This organization helps insurers prevent and solve fraud and is part of the Dutch Association of Insurers.
Simply make a report through the website, email cbv@verzekeraars.nl or call 070-333 85 00.
Frequently asked questions about insurance fraud
How is insurance fraud detected?
Insurers use sophisticated systems and specially trained fraud investigators to analyze suspicious claims. They watch for anomalous claim patterns, inconsistencies in statements and sometimes use outside experts or databases such as the CIS Foundation to detect fraud.
What are the penalties for insurance fraud?
Those caught committing insurance fraud will not be compensated and can be fined a minimum of €532. In addition, insurers can report the matter to the police, terminate insurance and recover investigation costs. Registration in the CIS register also usually follows.
How long do you stay registered as a fraudster?
A registration of insurance fraud in the Foundation CIS database remains visible in most cases for eight years. During this period, other insurers can view the report, which affects the conclusion of new insurance policies.
What are the consequences of a CIS registration?
A CIS registration as a fraudster makes it difficult to get any more insurance from regular providers. In addition, you often pay a higher premium and your application may be denied. Even with existing insurance policies, coverage may be adjusted or terminated.
What are examples of insurance fraud?
Examples include: declaring extra belongings after a burglary, reclaiming old damage, making a false report of theft or intentionally causing damage. Concealing a criminal record when applying for insurance also qualifies as fraud.
Can you still get insurance after fraud?
Yes, but not with regular insurers. De Vereende is one of the few insurers you can probably get. You do pay a high premium.
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