The latest developments across the P&C insurance industry regarding fraud, risk and compliance.
17 December 2015

Effectiveness of insurance fraud investigation increases

Insurance companies in the Netherlands have conducted more successful fraud investigations. In 2014 fewer investigations were started compared to 2013, but the percentage of proven fraud was higher: 35% in 2013 and 38% in 2014. Moreover, insurers saved more money in 2014 because of investigations. The effectiveness of these fraud investigations has saved 98,8 million euros in total, which is about 10% more than in 2013 (90 million). About 60% of fraud is committed at claims. Nevertheless, underwriting has a higher ratio when it comes to proven fraud (source: Dutch Insurance Association).

Meer effectiviteit bij fraudeonderzoekIn 2014, the investigations regarding insurance fraud have reached an amount of 20.388, which is nearly 15% less than 2013 (24.000). The investigations in 2014 delivered 7.762 proven fraud cases. This concerns mainly fraud at claims. Despite these rather positive results, there is still a high potential for improvement says Christian van Leeuwen (CTO, FRISS). ‘’Many insurers are not aware enough of the amounts of fraud that is committed and how easy it is for fraudsters to get away with it’’.

Read how the Swedish insurer Folksam is aiming for 15-20% more fraud cases to be investigated in 2016.

More fraud at underwriting
More proven fraud is found at underwriting, for instance when wrong information is provided or information is deliberately kept silent when applying for an insurance policy. The amount of proven fraud from investigations at underwriting lies around 50%, which is much higher than at claims (35%). ‘’Insurers are frequently underestimating the value of an extensive risk assessment at underwriting, which enables insurers to keep potential fraudsters out in the first place’’, says van Leeuwen.

View how insurer Reaal established an optimal cooperation between the underwriting and claims department, which contributed to the increase in proven fraud cases.

Property and casualty insurance
Figures from the Dutch Insurance Association show that 86,6% of the total amount of fraud investigations concern property and casualty insurance policies, which is slightly lower than the 88,3% in 2013. For the fifth time in a row more than half of all investigations concern car insurances (52,9%). Follow at a large distance by homeowners insurances (13,2%).

The amount of proven fraud cases in Belgium has increased with 50% in 2014. Belgium insurers are enhancing their means to fight the rising amounts of fraud attempts. The chance that fraudsters get caught are therewith higher. ‘’This will prevent honest customers from higher premiums because of these fraudsters. They will have to pay for it in the end’’, says the Belgium Insurance Association.

Sources: schade-magazine.com, verzekeringen.com

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