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Fraud policy

Trust is the basis for a good relationship with our customers. Unfortunately, this is abused by a small group of customers . Read here how we respond to fraud.

Trust is the basis for a good relationship with our customers. Unfortunately, research shows that a small group of customers are abusing this trust by committing fraud.

But what is fraud? Fraud can be defined as the abuse of an insurance product or service by the policyholder, insured or beneficiary to obtain a payment in money or kind to which they are not entitled.

Insurance fraud is being committed on a huge scale. The Covenant on Combating Insurance Fraud (Convenant aanpak verzekeringsfraude) includes several key figures that show the extent of insurance fraud. Every year, general insurers pay out approximately € 900 million in fraudulent claims. This is approximately 15% of the total annual claim amount. Approximately 10% of claims can be categorised as fraudulent. So, fraud has a significant effect on the cost of claims and, as such, on the result of the underwriting-agency portfolio.

Fraud is a punishable offence and also forces everyone to share in the cost of the fraudulent behaviour of others via their premiums. It is our social responsibility to tackle abuses of this nature, so that products continue to be affordable for other insured. We will do everything in our power to prevent insurance fraud as much as possible. This includes fraud management.

Insurance fraud has negative consequences for the image of our industry too. It is completely at odds with the image we want to promote, being one of security, reliability and continuity. In this context, the Dutch Association of Insurers (Verbond van Verzekeraars) has produced the Insurers & Crime Protocol (Protocol Verzekeraars & Criminaliteit). Its aim is for insurers to demonstrate a targeted social commitment and put general protection and detection measures in place to reduce fraud.

Our organisation places great importance on fraud awareness, because of which it is encouraged and supported by management and all the company’s employees. Our underwriting and claims handling process include steps to identify and control fraud aspects and fraud indicators. We are guided in this by the fraud control guide for authorised underwriting agents (Spoorboekje Fraudebeheersing voor Gevolmachtigden).

To reduce fraud, we carry out checks when underwriting insurance and handling claims. We also deliver claim data to the Foundation Central Information System (Stichting Centraal Informatie Systeem (CIS)). It uses the FISH software application to register claims history and specific fraud, which alerts other insurers.

Besides process controls, we also carry out a number of management controls to identify fraud retrospectively. These management controls are part of our Internal Control.

To promote knowledge and fraud awareness, fraud cases are discussed with acceptors and claims handlers.