Life

Many Australians take out a life insurance policy as a safety measure to protect their loved ones in the event of the policyholder's death, or to provide financial support if the policyholder is unable to earn an income due to illness or disability.

However, there are some individuals who secure a life insurance policy with the intent to defraud the insurance company. Other individuals might start out by holding a policy and identify ways to gain benefit by deception at a later time. Fraudulent life insurance claims have their part to play in raised premiums.

Life insurance frauds include:

    • Payouts for dishonestly claimed Total and Permanent Disability (TPD) benefits, provided by the life insurance policy
    • Less common but far more complex, faked deaths and disappearances which might entail the co-operation of other participants and forces the perpetrator to go into hiding or to change identity


There have been cases of people claiming to be suffering from unconfirmable but chronic pain, who appear publicly in wheelchairs yet seem to be able to play strenuous sports, do demanding gardening tasks or cope easily with heavy lifting. 

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.