Investigation into insurance fraud
There has been a significant increase in the amount of reports of insurance fraud. The other day a record number could even be announced. However, there is a difference between the number of fraud investigations and the number of cases actually detected. When fraud is suspected, an insurer does have to be able to demonstrate and prove whether fraud actually occurred. Therefore, when there is a suspicion, an investigation is launched and what such an investigation looks like, we explain here.
When does the insurer investigate fraud?
When you file a claim, the insurer may have it examined to see if a submitted claim is fair. Often claims are automatically reviewed by a system, such as by looking at a certain limit amount for the claim. for example, the limit amount for car damage is €1,000, and for damage to a bicycle it is €500. There are also a number of signs that can be construed as noticeable, such as a number of claims within a short period of time or if you change the insurance and make a claim shortly after the change. These are all reasons for an insurer to proceed with an investigation.
In doing so, when an application is made, the insurer always checks the personal information and identity of the person in question. If there is reason to believe that the information provided by the applicant is incorrect, the insurer may also order an investigation. This then involves suspicion of fraud, as this is a form of insurance fraud.
Investigating insurance fraud
There are several investigative methods that insurers can use to identify all forms of insurance fraud, for example:
- An insurer may hire a research firm or expert to ask some questions of the insured or other parties.
- An insurer can collect personal information from various channels, such as the Land Registry, the RDW license plate register and from the Chamber of Commerce. Of course, the Internet is also a great source of information. furthermore, information can also be obtained from tip-offs or witnesses.
- Information can be gathered by observing, conducting an accident analysis or note check, deploying fire (technical) investigation, or investigating for signs of forced entry.
- Use can be made of information resulting from the so-called warning system, which is used by financial institutions, among others. This system contains the personal data of people who are at risk.
- The use of predictive software. This is the capability most insurers use. This software can distinguish between claims that can be accepted immediately and those that require further investigation first because of suspected insurance fraud.
Some investigations are conducted by the insurer itself, but they may also have this done by using an outside investigative firm or expert. If it is actually determined that fraud has occurred, there are some consequences. One example is that the investigation costs incurred will be recovered from you.
Avoiding research: avoid misunderstandings
Of course, it is also possible that there has been a misunderstanding, after all , mistakes are human. You really will not immediately be seen as a fraud by the insurer. To avoid a misunderstanding, it is important that you fill in and check the details correctly when completing an insurance application. Do you have any questions while filling out an application? If so, please be sure to contact us. We will be happy to help you and give you more clarity. We can be reached by phone from Monday to Friday from 8 a.m. to 6 p.m. at 088 - 688 37 00 or send us a message via Whatsapp, Facebook Messenger or via our chat.
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