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6 ways insurers pick out FALSE claims

Last updated on: June 20, 2013 18:02 IST

6 ways insurers pick out FALSE claims

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From mining through claimants' social media updates to performing a background check, insurance companies have their own set of measures to sniff out whether the statements of the claimant are true or not. Beware!

Insurance is a financial product that is sold on mutual trust. IRDA, the governing body for insurers, makes sure insurance companies do not breach this trust. But there's no such governing body on customers buying insurance and that is why insurance as a financial product is so vulnerable to frauds and fake claims.


The cases of fraudulent insurance claim is on rise. In such a scenario, the insurance industry cannot afford to act sluggish or it will end up losing millions and millions of rupees.

Insurance companies have their own set of measures to sniff out whether the statements of the claimant are true or not. They have keen eye experts that sew up whether the eventuality happened by accident or by design.


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1. Mining through the claimant's social media profiles

More often than not, people are rather outspoken on a social media platform, even more than they are in real life. Experts try to delineate the claimant's latest uploaded content on a social media and pin out anything dubious relevant to claims.

2. Performing the claimant's background check

If the need arises, the insurer have all the resources at its disposal to delve deep into the claimant's database, primarily the claim history and credit history. These two parameters are a reflection of the credibility of the claimant's statement.

A high debt claimant with a frequent claiming habit will surely be put on the company's radar. Because only those who are in desperate need of money resort to such fraudulent measures.


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3. If the insurer had increased the cover shortly before an eventuality, that is a probable sign that the eventuality was deliberately planned by the insured in advance. This will go both for motor insurance and health insurance.

4. The whole fraud thing becomes foolproof when professionals like doctors and car mechanics get involved in assisting the claimant, by providing her/him bills for services s/he never take. In such cases, the claimant provides hand written receipts for supporting her/his statements.

On the basis of doubt, insurance companies put such professionals under scanner. When fraud claims are made and the insurers are slapped with high bills from such professionals, it becomes a sure sign that the claim is fraudulent.


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5. A carefully planned accident always leave behind certain traces. Insurance companies take the help of specialised investigation units which interview the claimant and witnesses and try to identify if it's a fraud.

Some miscreants think that burning down the insured commodity will leave no traces for further investigation. But this is far from truth. For say, when a car is burned down, the investigation team has tools and techniques like burn pattern analysis that discloses whether the fire was deliberate or accidental.

In case of a car theft, they would look out for the signs of forced entry.

6. Fraudsters who are not seasoned enough, give away the most obvious signs, the most common of which is acting totally calm and composed when filing a claim, even if it's for a catastrophic eventuality like burglary, car theft, house fire and so forth.


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