Fraud Policy

We define fraud as knowingly misleading or prejudicing a financial service provider in order to benefit the policyholder, insured or beneficiary financially.

Examples of fraud include:

• not giving up information honestly;
• Not telling honestly what happened;
• amounts change on purchase notes;
• claim more than the actual damages;
• resubmit a previously rejected claim with a different story.

We take several measures to recognize and address fraud early:

• Our staff is trained to recognize fraud indicators.
• We and insurers use computerized knowledge systems specifically designed to detect fraud.
• We have appointed a fraud liaison to ensure compliance with our fraud policy.
• Claims history data and specific fraud information are processed in FISH, a system that helps detect fraud.
• We conduct audits in accordance with the Sanctions Act (CDD).

If we suspect someone is committing fraud, we investigate further according to insurer and industry guidelines.

Does that investigation reveal fraud? Then we can take the following measures (in consultation with the insurer involved):

• Termination of all insurance policies. Not only the policy to which the fraud relates, but also other current policies.
• Report it to the police.Report personal data in the incident alert system financial institutions.
• Recover amounts paid out and expenses incurred.
• Do not proceed with disbursement.
• The severity and culpability of the fraud determine what measures are taken.

In doing so, we look at, among other things:

• the social and business damage;
• Whether there is organized fraud;
• who are victims;
• which is the correct and complete information.

A standard indemnity of €532 applies to internal investigation costs in claims.

This amount is recovered by SODA (Service Organization Direct Liability).

In addition, SODA can also recover:other expenses incurred on behalf of the insurer;

• recover wrongfully paid damages.
• Is fraud involved when applying for insurance? Then we may additionally charge internal costs of € 101.
• Learn more about SODA at www.so-da.nl.