Every working day, tens of thousands of commuters drive along the A2, A12 and A27 towards Utrecht CS. A single reported ‘accident’ on one of these roads may, however, form part of a larger pattern. Insurance fraud also affects the wallets of honest premium payers here.
The main manifestations of insurance fraud
1. Fictitious damage claim
Damage that never occurred is nevertheless reported. Consider a bicycle that was supposedly ‘stolen’ at Utrecht Centraal station but had in fact already been sold. False documents are often used.
2. Exaggeration of actual damage
The damage is real, but the amount is greatly inflated. Examples:
- Household contents lists including items that were never in the dwelling
- Quotations for repairs that do not correspond to reality
- Claims for non-pecuniary damages in cases of minor complaints
3. Non-disclosure at inception
Intentional non-disclosure falls under the duty of disclosure (article 7:928 BW). Where deception is proven, the matter shifts towards fraud.
4. Identity fraud
Policies are taken out in the names of deceased persons or claims are submitted under another identity, often linked to money-laundering practices.
5. Organised fraud
Networks stage accidents, particularly around the A27 and A12 near Utrecht. False medical statements and fraudulent garages generate losses of tens of thousands of euros per case. Insurers and the police cooperate with the CIS to dismantle these networks.
Legal consequences of fraud
Civil-law consequences
- Recovery of amounts paid out
- Extrajudicial costs borne by the fraudster
- Policy termination and exclusion from other insurers
- Registration in the CIS for five to eight years
Criminal-law consequences
Insurance fraud constitutes fraud (oplichting) (article 326 Sr): a maximum of four years’ imprisonment or a fine of up to € 90,000. In the case of organised networks, article 140 Sr may result in six years’ imprisonment. The Public Prosecution Service at the Rechtbank Midden-Nederland (Utrecht) takes such cases seriously.
Professional and social consequences
A conviction may lead to loss of a VOG (certificate of conduct), difficulties with mortgages and exclusion from financial professions.
Modern methods for detecting fraud
Since 2010, insurers have been using advanced tools:
- Big-data analysis: patterns in claim frequency and location
- CIS check: verification against the central database
- Social-media investigation: inconsistencies on Instagram or Facebook
- Surveillance: private investigators and internal fraud departments
Steps in the event of an unfounded accusation
Have you been wrongly accused? Proceed as follows:
- Request written substantiation
- Respond factually with evidence
- Instruct a lawyer immediately
- Consider proceedings before Kifid or the civil court
- Request removal in the event of an incorrect CIS registration
For advice in the Utrecht region, you may contact the Arslan office at Vredenburg 40, 3511 BD Utrecht (030 - 8200 200) or the Juridisch Loket Utrecht.
Conclusion
Improved detection is making insurance fraud increasingly risky. The average fraud case yields only € 1,500, yet the consequences last for years. The short-term gain rarely outweighs the long-term damage.