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About Insurance Fraud

What is insurance fraud? 

Most Australian insurance policyholders are honest, and file claims with genuine reason. However, some policyholders lodge dishonest claims. These may include faking an accident, theft or injury (to greater or lesser degrees) in order to deceive an insurance company or agent to collect money to which they aren’t entitled.

Some common methods of fraud include:

      • Claiming for loss, damage or injury that never occurred
      • Exaggerating an otherwise legitimate loss, damage or injury
      • Claiming for unrelated, non-existent or pre-existing injuries
      • Causing arson or other intentional property damage
      • Staging accidents with the intent to submit a fraudulent claim
      • Conspiring to support those involved in a fraudulent claim


How fraud affects us all


When you pay your insurance premium, your money is pooled with that of other policyholders to form a fund from which claims are paid. We all share the risk. That means insurance fraudsters are stealing directly from their fellow policyholders. The more fraudulent claims get passed through the system, the higher premiums become because of the larger risk revealed by claims statistics.

It doesn’t matter how big or small the deception is: when an insurance company is forced to pay out more money by way of claims, they have little option but to raise the premiums of their customer base. This issue affects us all because one way or another, honest consumers and businesses pay the price.

People of all incomes, ages and nationalities are both perpetrators and victims of insurance fraud. Estimates show that honest Australian policyholders are contributing about $400 per family to compensate for insurance fraud crime, or about $100 per premium. What is clear is that insurance fraud comes at a huge cost to the community; now empowered by the national Insurance Fraud Hotline to report it.

There are several types of insurance fraud, corresponding with the different types of insurance. Insurance fraud types include Workers Compensation; Motor Vehicle; Property; Arson; LifeHealth and Other (such as Public Liability insurance). Please click on the links or see the drop down menu options to read more about each type.

As with all insurance fraud, the pocket it ultimately hits is yours.

If you have information that you believe in good faith is insurance fraud, report it NOW!

Types of Fraud

Workers Comp

This can include employees falsely receiving benefits such as time off work, by faking injuries, exaggerating legitimate ones, claiming for pre-existing injuries or those sustained that have no relation to the workplace.

Motor Vehicle

This type of fraud takes many forms, including claiming theft in order to obtain money for an unsaleable car, or to cover up 'drink driving' accidents; staging car accidents; or vehicle arson.

Property

Goods that are unsaleable due to their poor condition, quality or lack of market demand, may also be fraudulently 'lost' or 'destroyed'. In the case of buildings and plant equipment, arson is often involved.

Arson

Insurance arson typically involves the intentional burning of insured property in order to destroy it and claim its insured value, especially when this is greater than the item's saleable value.

Life

A typical example of life insurance fraud might be a person claiming a monthly benefit - while working another job on the quiet. More extreme examples include elaborately faking deaths and disappearances for the fraudster and any accomplices to secure the payout.

Health

Fraudulent acts include healthcare or medical professionals billing for services not performed, claiming higher than actual costs, participating in the treatment of 'patients' brought in as a result of staged accidents, or carrying out unnecessary procedures.

Other

People might claim falsely for injuries relating to falls (called 'slip and fall' accidents) or other incidents where the consequences can be exaggerated.