Life insurers catch more fraudsters

Comment on this story


Crime_scene1

Independent Newspapers

.

South African life insurers have reported a significant increase in the value of prevented fraudulent death‚ disability and funeral cover claims in 2011.

Claims fraud statistics released by the Association for Savings and Investment South Africa (ASISA) this week show that the value of death‚ disability and funeral claims involving fraudulent documentation and syndicate activity has jumped from R26.2-million in 2010 to a whopping R131.7-million in 2011. The actual number of these claims increased from 452 in 2010 to 545 in 2011.

Peter Dempsey‚ deputy CEO of the Association for Savings and Investment South Africa (ASISA)‚ says while a small portion of these claims were paid before fraud was detected‚ most of the fraudulent claims in 2011 were uncovered by life insurers before money was lost.

“Life companies are often seen as soft targets by criminals hoping to access benefits through fraudulent means. Life companies have‚ however‚ put sophisticated fraud detection mechanisms in place to allow for early detection.”

Dempsey says while fraudulent claims have shown a marked increase‚ claims involving dishonesty rather than criminal intent have shown an impressive R142-million decrease from R605.6-million in 2010 to R463.6-million in 2011. He explains that this is mainly due to a substantial drop in misrepresentation and material non-disclosure across all types of cover.

Misrepresentation occurs when a policyholder deliberately provides misleading information to a life insurer‚ for example adding someone else’s child to a funeral policy‚ pretending that it is your own child.

Material non-disclosure refers to the deliberate failure of policyholders to disclose information about a medical or lifestyle condition‚ which is material to the assessment of the risk to be insured. An example of material non-disclosure is when an applicant for life cover omits to mention that he or she participates in dangerous sports. Another example would be not disclosing a serious back injury when applying for disability cover.

In 2011‚ a total of R599.7-million dishonest and fraudulent claims were detected‚ compared to R638.3-million in 2010 – a R38.6-million decrease.

Dempsey warns that insurers are increasingly taking a zero tolerance approach to claims involving any kind of fraud‚ which may result in a criminal investigation and even prison. - I-Net Bridge


sign up
 
 

Comment Guidelines



  1. Please read our comment guidelines.
  2. Login and register, if you haven’ t already.
  3. Write your comment in the block below and click (Post As)
  4. Has a comment offended you? Hover your mouse over the comment and wait until a small triangle appears on the right-hand side. Click triangle () and select "Flag as inappropriate". Our moderators will take action if need be.

     

Join us on

IOL-Social networks IOL-Social networks IOL-Social networks IOL-Social networks