Understanding insurance fraud and its consequences

Insurance is about gathering money from premiums to help people who have losses covered by their policy. When fraud happens, there’s less money to go around. This makes premiums more expensive for everyone.

Insurance fraud may appear to be a shortcut for quick financial gain, but the repercussions can be severe and long-lasting. While the motivations behind insurance fraud vary, its impact is universally detrimental, not only for insurance providers but also for policyholders. 

What is insurance fraud?

Insurance fraud involves any form of deception directed at an insurance provider. It varies in scale and can range from seemingly minor infractions to substantial, orchestrated schemes. Common types of insurance fraud include:

  • Making false statements to support a claim.
  • Falsely adding items that weren’t affected to your claim.
  • Creating a fake situation or staging a claimable event.
  • Claiming the same item multiple times.
  • Withholding vital information, such as past criminal convictions or declined claims.
  • Making a claim for an incident that occurred before your policy was in place.

Knock-on effects of insurance fraud

One of the immediate consequences of committing insurance fraud is the decline of your claim and the cancellation of your policy. Here are some of the further implications:

  • Difficulty obtaining future insurance: If you are caught committing insurance fraud, you may find it challenging to secure insurance in the future. This can create a ripple effect of complications.
  • Home ownership barriers: If you can’t obtain insurance, buying a house becomes difficult, if not impossible, because most mortgage providers require home insurance as a condition of the loan.
  • Altering excess and making immediate claims: There have been occassions where we’ve noticed a pattern of individuals changing their policy excess amount and then making a claim the very next day. This is a red flag for insurance providers and could result in the claim being declined.
  • The insurance claims register: If you’re found committing insurance fraud, your details may be flagged in an industry-wide Insurance Claims Register, making it challenging to secure any type of insurance going forward.
  • Legal consequences: Beyond these financial and practical outcomes, insurance fraud is illegal and can lead to prosecution. In severe cases, you could receive a criminal conviction.

The importance of the date of loss

Choosing an incorrect date for when a loss occurred can also be considered a form of fraud. The date of loss is crucial for determining the policy terms that apply and for establishing whether the claim is valid. Misrepresenting this date could result in a denied claim or worse.

Consequences summarised

Being dishonest or omitting details when dealing with your insurance provider may seem like a small act at the time, but it has significant ramifications:

  • Claim decline and policy cancellation.
  • Future insurance barriers.
  • Potential legal issues.
  • Financial strain due to an inability to secure loans or buy a house.

Final thoughts: be honest

Insurance is a cornerstone of financial planning, offering a safety net for unforeseen circumstances. Fraud undermines this system for everyone involved. By understanding the gravity of insurance fraud and its consequences, you can make informed and honest decisions when dealing with your insurance provider.


Non-Disclosure and what to tell your insurance provider