Insurance fraud: what is it and what are its implications?

Insurance fraud: what is it and what are its implications?

Insurance fraud comes in a few different shapes and sizes. Some types of fraud are done on purpose, some types involve small lies that may seem like they won’t matter, and some are committed without the person committing them even realising.

“The cost of insurance fraud each year is big — it’s in the billions”

The cost of insurance fraud each year is big — it’s in the billions — and while it may seem easy to ignore these costs because they only affect insurance companies, the reality is that insurance fraud ends up costing you and others, be it in the form of higher premiums, higher excesses or policies with more things an insurer won’t cover — all of which are aimed at cutting down the increasing costs of fraud.

But what exactly is insurance fraud? And how can it be avoided?

What are the types of insurance fraud?

Insurance fraud generally falls into a few categories: non-disclosure, exaggeration and deliberate;

  • Non-disclosure can be both deliberate and inadvertent. Fraudulent non-disclosure basically means that you haven’t revealed information to an insurer that might affect their decision to insure you or to pay out a claim. For example, when applying for car insurance, you may neglect to mention a conviction for drink-driving or you may tell your insurer that your car is always parked in a secure garage overnight when, in fact, it’s typically parked on the street. It’s important to note that even unintentional non-disclosure is still fraudulent.
  • Deliberate fraud is premeditated and calculated in an effort to defraud an insurance company. That is, someone planned to commit fraud to make money. Common types of deliberate fraud include setting fire to property or faking a theft in order to receive an insurance payout.
  • Exaggeration is pretty straightforward and is mainly limited to when a person makes a claim — it involves exaggerating the amount of damage or the cost of the loss in order to increase the payout of a claim.

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As you can see from the various types, insurance fraud isn’t limited to criminals. Even well-behaved people can often be tempted to leave out important information or inflate the value of a claim for their own personal gain, and it can also be the case that a person doesn’t realise they are committing a crime by exaggerating the facts or failing to disclose important information.


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Important disclaimer – Watkins Insurance Brokers Pty Ltd ABN 23 059 370 455, AFSL 244427.

The views expressed are those of the author only and do not necessarily reflect those of Watkins Insurance Brokers Pty Ltd.

This magazine provides information rather than financial product or other advice. The content of this magazine, including any information contained on it, has been prepared without taking into account your objectives, financial situation or needs. You should consider the appropriateness of the information, taking these matters into account, before you act on any information. In particular, you should review the product disclosure statement for any product that the information relates to it before acquiring the product.

Information is current as at the date articles are written as specified within them but is subject to change. Watkins Insurance Brokers Pty Ltd make no representation as to the accuracy or completeness of the information.

This article has been reproduced with the consent of Steadfast Group Limited.


Source: – https://www.steadfast.com.au/well-covered/insurance-for-established-business/insurance-fraud-what-is-it-and-what-are-its-implications