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What is insurance fraud?
Insurance fraud is defined as: “the deliberate falsification of information by a claimant, in order to obtain a financial advantage or gain.”
Insurance fraud may be:
- Opportunistic — The exaggeration of otherwise legitimate claims
- Premeditated — For example: arson, theft, or staged incidents involving the fabrication of a claim
- Based on non-disclosure — Misrepresenting or hiding facts relevant to a claim
- Organised — With criminals coordinating large and complex false claims.
Is insurance fraud REALLY a victimless crime?
It’s commonly believed that insurance fraud is a “victimless crime” — that the only ones to suffer a loss are large, faceless insurance companies.
In research carried out by the Insurance Council:
- 25% of people interviewed claimed to know somebody who has committed insurance fraud,
- 20% supported the practice of “padding” or exaggerating insurance claims, and
- 38% believed that insurers can afford the cost, and that there are no losers.
However, since insurance fraud is a cost on the provision of insurance, it’s the policyholders who are ultimately forced to bear this cost through higher insurance premiums.
Is insurance fraud affecting YOUR business?
If so, you’re not alone, insurance fraud is a very real issue for many Australian businesses.
Evidence suggests that up to 15% of insurance claims in Australia might be fraudulent, and that literally billions of dollars are paid out to settle insurance claims each year in Australia. If even 10% of this money is falling into the wrong hands, it’s an expense your business (and other’s like it across Australia) should not have to endure.
If you suspect fraudulent insurance claims, it's imperative you obtain cold-hard facts as soon as possible. So, you are able to legally provide the framework of your case against the perpetrators. You have a clear responsibility to minimise any risk to your enterprise.
From our files:
An insurance fraud case study
In this case, a policyholder claimed against their insurance company for injuries incurred in a road accident. The claim was flagged as suspect and CA Investigations was called in to investigate. Part of the investigation involved finding evidence, which would point to the cause of the accident.
As the police had attended to the accident more than two hours after it had happened, they were too late to administer a Breathalyzer test. Investigation however, uncovered evidence of alcohol consumption prior to the accident. This was admitted as evidence in court and the claim was reduced.
Need an insurance fraud investigation done?
You can depend on the team from CA Investigations to diligently investigate insurance claims on your behalf and provide clear, accurate, and comprehensive reports — delivered on time.
You'll gain access to the up-to-date progress on your case — available to you 24/7 from anywhere in the world, via your secure log in. Wherever possible your report will include high quality video and photographic evidence as well.
Reliability. Efficiency. Accuracy. Discretion. That's our promise to you. To get to the truth of the matter, contact us using a method convenient to you — or simply call us on (07) 3869 0111.
