Fraud prevention policy
Trust is the basis for a good relationship between a.s.r. and its customers.
Various studies have shown that there is a small group of customers who break this trust. They commit fraud. The same studies also demonstrate that a vast majority of customers believe that we should crack down hard on insurance fraud. This is not surprising: the more instances of fraud, the higher premiums will rise. And that is clearly something we want to avoid, for instance by checking policy applications before we accept customers and verifying whether claims are justified.
If you are confused about a certain question when completing a policy application, you are welcome to contact us or your adviser. We are also happy to be of assistance if you do not know how to report a claim or what information to provide to a.s.r. in the claims process. This is how we can help each other to prevent misunderstandings.
How do we define fraud?
a.s.r. defines fraud as the deliberate deception of a.s.r. for the benefit of the fraudster or a third person. The fraudster gives a false representation of the facts with the aim of, for instance, taking out a policy, receiving benefits or pulling in higher benefits than what they would otherwise be entitled to. Instances of fraud include:
- Misrepresenting information to a.s.r. (e.g. in a policy application).
- Being untruthful about what happened.
- Changing amounts on invoices.
- Submitting claims that exceed actual losses suffered.
- Resubmitting rejected claims while fabricating a new context.
- Causing damage intentionally and pretend it was an accident.
- Feigning a personal injury or exaggerating a personal injury.
Fraud management coordinator
a.s.r. employs qualified people who specialize in preventing, detecting and fighting insurance fraud. They work as fraud management coordinators and are listed in the Register of Chartered Fraud Management Coordinators. This Register falls under the remit of the Dutch Association of Insurers and is managed by the Dutch Institute of Register Experts (Dutch acronym: NIVRE).
How does a.s.r. detect fraud?
We use different methods for getting at the truth and detecting fraud. Our detection methods obviously comply with the relevant rules and regulations, including the Dutch Personal Data Protection Act and the Code of Conduct for Investigating Persons. We can, for instance, investigate – or commission an investigation into – someone's behaviour or collect information – or have information collected – that might be relevant to accepting a policyholder, assessing the right to damages or determining the level of insurance benefits. In doing so, we may collect and process personal data that were obtained using alternative methods and from other sources than the policyholder or prospective policyholder personally. The public sources we use include the vehicle registration system of the National Vehicle and Driving Licence Registration Authority (Dutch acronym: RDW), Chamber of Commerce registers, the Land Registry Office and the internet. At times, we also receive information from other persons, such as informers or witnesses.
We may collect information by conducting a forensic, tactical or personal investigation or ask another body to conduct such an investigation. This might include keeping persons under surveillance or interviewing them, performing an accident analysis, checking invoices, conducting a forensic fire investigation and investigating signs of forcible entry. We also make use of relevant information from warning systems for financial institutions, we can exchange information with other insurance companies and we use predictive software. This software distinguishes between claims that are approved without further examination and claims that need to be reviewed for the possibility of fraud.
Some types of investigations we perform ourselves, but for others we engage the services of external investigation agencies. These engagements are subject to contractual conditions. An external agency is expected to comply with the rules and regulations for conducting investigations and processing personal data.
What does a.s.r. do in case of a suspicion of fraud?
As soon as we have gathered enough evidence to argue that a policyholder may have acted fraudulently, the person or persons involved are notified. We either do this ourselves or we ask an investigation agency to do it for us. The person or persons involved will then be given the opportunity to explain themselves. Based on the information we receive, we decide whether or not to take action.
What action does a.s.r. take in case of fraud?
If an instance of fraud has been identified, we can decide to:
- Refuse to compensate for losses suffered.
- Recoup the costs of the investigation and reclaim any benefits paid earlier.
- Cancel all outstanding non-life policies and any other contracts with the fraudster.
- Refuse to enter into any contracts with the fraudster in the future. We may broaden this exclusion to all labels and business lines of ASR Nederland N.V.
- Enter the fraudster's personal data in our internal incident register.
- Share these personal data with the Central Information System (in Dutch: Stichting CIS). Through CIS, insurers operate a warning system to prevent and fight fraud. Affiliated insurance companies enter personal data in this system for consultation. Further details are provided in the Protocol for Incident Warning Systems for Financial Institutions. For more information, please visit the CIS website: www.stichtingcis.nl.
- Share the personal data with the Centre for the Prevention of Insurance Crime of the Dutch Association of Insurers.
- File a police report.
The standard fee to compensate for the internal investigation costs is € 532. This fee is billed by SODA, the service organization for liability claims. In addition to the standard fee, a.s.r. can also ask SODA to recoup other undue costs or unduly paid benefits or damages. For more information about SODA, see www.so-da.nl (in Dutch).
Will a.s.r. file a police report?
We will go to the policy if we detect fraud or have a serious suspicion of fraud based on the evidence we have gathered.
How do we inform the fraudster?
The fraudster is informed in writing of the action we have taken.
How to report fraud
If you suspect a policyholder or another a.s.r. business contact of having committed fraud, you can report your suspicion by sending an email to the Security department on firstname.lastname@example.org.
You can also reach the Security department during office hours on 030-2786572 if you prefer to talk to someone about your suspicion. If you prefer to file an anonymous report, please contact Meld Misdaad Anoniem (Crime Stoppers NL) on 0800-7000.
Because we need to be able to link up your information to the right claim, we would ask you to specify the following information in your email:
- claim number (if known)
- name, address, date of birth of the person or persons involved
- nature of the fraud
- manner in which you came in possession of the information
- your contact details if you are willing to provide additional information to a.s.r.
If you specify this information, your report will land directly on the desk of one of our fraud management coordinators, who will treat it confidentially and with due care.