Fraud

Fraudulent and dishonest claims are a major problem for the insurance industry and fraud is suspected in a number of the cases we see. These can be difficult to assess. To establish that fraud has taken place, some concrete evidence of exaggeration, false or inconsistent statements or acts of deception must be present.

Fraud may take the form of an isolated incident and to be committed by an opportunistic fraudster or form part of organised fraud.

The identification of potential fraud may take place at any stage of a claim. There are many indicators, the use of which enables the questionable claim to be recognized and appropriate action taken.

Our objectives remain to:

• Increase the awareness of staff to the fraud issues
• Highlight some of the key fundamental indicators specific to travel insurance
• Highlight the areas for consideration of questioning claimants, against the benefits or advantages sought by the claimant.
• Suggest checks that may be made to remove concerns or refute suspicions
• Identify the need for more detailed investigations
• Reduce inappropriate claims spend