How is insurance fraud investigated?
The number of reports of insurance fraud is rising rapidly. In fact, recently a record number of insurance fraud cases have been identified. There is a difference here, however, between the number of fraud investigations and the number of fraud cases identified. After all, an insurer must be able to prove that fraud actually occurred. Therefore, when they suspect insurance fraud, they always launch an investigation. We explain here how insurance fraud is investigated.
When does an insurer investigate insurance fraud?
Are you filing a claim? If so, the insurer may start investigating whether the claim is legitimate. Claims are often reviewed by an automatic system. For example, there is a certain limit above which a check can automatically be performed. For car damage, for example, this is €1,000 and for a bicycle €500. There are also a number of signals that are picked up by default. For example, if you claim the same damage within a short period of time. Or if you have changed the coverage of your insurance and claim a damage immediately afterwards. These are all reasons for an insurer to investigate.
In addition, when applying for insurance, an insurer always checks the identity of the applicant. Is there reason to believe that something is not quite right about the data entered? Then the insurer may launch an investigation. After all, insurance fraud is also the failure to provide honest information while applying for insurance.
Insurance fraud investigations
Insurers use a variety of investigative methods to detect fraud. For example, they may:
- Engage a premises investigator to interview the insured or third parties involved.
- Collect personal data from various sources, such as the RDW's vehicle registration register, the Chamber of Commerce or the Land Registry. Of course, the Internet is also an important source of information. In addition, they can also collect information from tip-offs or witnesses.
- Gathering information through observation, accident analysis, note checking, fire (technical) investigation or investigation of burglary traces.
- Using information from the financial institution alert system. This system contains the details of individuals who are at risk.
- Deploy predictive software. Most insurers use this. This software distinguishes between claims that are approved immediately and claims that must be investigated because of suspected fraud.
Some investigations the insurer conducts itself, but they may also outsource it to an outside investigation firm or expert. Has insurance fraud been identified? Then there are some consequences. You will have to pay for the investigation costs incurred.
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Research avoidance: avoid misunderstandings
There can always be error, of course. After all, a mistake is easy to make. An insurance company will not see you as a fraud. However, it is important that you check the information carefully when filling out the insurance application to avoid misunderstandings. Is a certain question not entirely clear while filling out the application? Then please contact us! We will be happy to provide you with clarity. You can reach us Monday through Friday from 8 a.m. to 6 p.m. by phone at 088 - 688 37 00 or send us a message via chat, WhatsApp or Messenger.
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