10 Things You Don’t Realise Were Insurance Fraud

One thing about those chickens? They will come home to roost; just look at the likes of Elizabeth Holmes. Also, ‘honesty is the best policy’ isn’t just a saying, at least not in insurance. However, many people, perhaps even unknowingly, engage in fraudulent practices when it comes to their policy and coverage. 

In the insurance industry, honesty is the foundation for fair and adequate coverage.

So, if you’re purposefully misleading your insurance provider, we beg you to reconsider. The Swindler lifestyle will eventually catch up to you.

Inspired by Naked Insurance's enlightening article, we're diving into ten ways you might unknowingly commit insurance fraud. 

Falsifying Information

“It’s just a little white lie”, except it isn’t; you’re falsifying evidence. Things like lying about your insurance history or omitting the truth about specific details to get a lower premium have serious consequences; we’re talking about the legal kind. 

Being guilty of insurance fraud will inevitably lead to policy cancellation, leaving you without coverage, denied claims and, in severe cases, legal penalties that include fines or imprisonment.

Here’s an example of the eight common lies people tell:

  1. Non-disclosure of car modifications.
  2. Lies about your licence.
  3. Not declaring previous claims.
  4. Misrepresenting where the vehicle will be kept overnight.
  5. Not saying what the car is used for.
  6. Withholding motoring convictions.
  7. ‘Fronting’ – insurance in the name of a more experienced driver.
  8. Deliberately underestimating how far you drive every year.

While you might think your actions are harmless or that it’s okay because “everyone does it”, the trouble isn’t worth getting into. 

So, the next time you consider lying about where you park your car or how safe your valuables are, don’t. Your safety, that of your items, and your financial security depend on the truth you tell.

Concealing Modifications

What happens in darkness will come to light, just like those modifications you desperately tried to conceal. Whether for aesthetics or performance, changes can significantly alter your car’s risk profile, something your insurer needs to be made aware of.

Insurance companies assess risk based on the vehicle's factory specifications; any alterations can void your policy. 

Not to mention, failing to report these changes can lead to nasty surprises during the claim stage. Modifications can increase the likelihood of accidents, theft and higher repair costs. 

Therefore, informing your insurer about any modifications is crucial to ensure your coverage accurately reflects your car's condition. Total transparency means adequate coverage and protects you from potential financial pitfalls in the event of a claim.

Fronting/Using Someone Else as the Primary Driver

Hiding behind another regular or primary driver, a.k.a ‘fronting’, is another common insurance fraud tactic you should avoid at all costs. 

In car insurance, fronting is a deliberate deceptive practice where a lower-risk driver, like a parent or older guardian, is falsely listed as the primary driver. In contrast, the actual regular driver is high-risk, usually a younger or less experienced driver. 

Insurers calculate premiums based on the risk profile of the primary driver, and fronting distorts this assessment. This is undoubtedly insurance fraud as it purposefully misrepresents who is driving the most to achieve lower insurance premiums. 

However, the intent behind this isn’t always malicious. 

Unintentional fronting can occur in families; parents might list themselves as the primary driver of a car frequently used by their teenage child, not realising this is an act of fraud. Similarly, a car owner might add a relative who uses the car more as a secondary driver, not understanding the implications. 

We’re trying to say that accurately representing the primary driver is crucial. 

If not, you’ll find yourself with a cancelled policy, increased premiums, and denied claims in the event of an accident.

Undervaluing the Car

That’s right, what could be a simple miscalculation is actually considered fraudulent behaviour. And if it’s not a mistake, but done on purpose, undervaluing your vehicle is a risky strategy that can backfire financially.

While lowering your car’s value might reduce your premiums in the short term, the long-term consequences are severe, especially when filing a claim. Insurance bases compensation on the declared value of the vehicle. 

So, if your car is undervalued, in the event of theft or total loss, you'll receive less compensation than you need, leaving you to cover the remaining difference out of pocket.

This discrepancy becomes apparent in accidents involving grave repairs or a total write-off. You might be unable to replace your vehicle or pay for necessary repairs. 

That’s why providing your car’s precise value is essential when applying for an insurance policy. 

Doing so ensures you receive coverage that matches your vehicle's actual value, providing adequate financial protection and peace of mind.

Exaggerating Injuries or Damages

The only people who exaggerate injuries more than soccer players trying to get a free-kick are insurance fraudsters. This dishonesty carries hefty consequences like fines, criminal charges, and potential imprisonment. 

Plus, it undermines the trust-based insurance system, increasing premiums for all policyholders.

Exaggerating injuries or damages leads to more rigorous investigations involving medical professionals and repair specialists, potentially delaying legitimate claims.

Medical professionals play a crucial role in verifying the extent of injuries. Their expert assessments and reports are pivotal in substantiating claims. Similarly, repair estimates from certified mechanics or body shops help verify the extent of damage. 

So, insurance providers rely heavily on these professional evaluations to determine the legitimacy and value of claims.

So, let’s leave the acting and pretending to your favourite football player. You’ll never regret playing by the rules, especially if it means avoiding claim denials, policy cancellations, and legal action. 

Ghost Brokers

No, not the famous phantom-hunting group from those cool movies. 

Ghost brokers are the ultimate fraudsters, selling forged or invalid discounted insurance policies to unsuspecting consumers. Victims find themselves uninsured, facing legal penalties for driving without valid insurance, and financially liable for any damages or injuries from accidents. Worst still, fraudsters can use personal information shared for identity theft or other fraudulent activities.

Here are a few tips to help you spot a ghost broker from several kilometres away:

  1. Verify credentials: Always check the broker's credentials. Legitimate brokers are registered with national insurance regulatory bodies like The Financial Sector Conduct Authority (FSCA) and the Prudential Authority (PA), which act as the regulators of the South African insurance industry along with the International Association of Insurance Supervisors (IAIS), African Insurance Organization (AIO), and the South African Insurance Association (SAIA) act as the other supervisors.
  1. Beware of meagre prices: If a deal seems too good to be true, it probably is. Extremely low premiums can be a red flag for fraudulent activity (unless they’re from Pineapple, of course. We’re all about offering quality insurance at a reasonable price).
  1. Secure payment methods: Be cautious of brokers asking for payment in cash or through untraceable methods. Legitimate brokers won’t do this; they usually accept payments through secure channels (debit or credit cards, bank transfers, and online payment gateway services like PayPal).
  1. Professionalism and transparency: Authentic brokers provide clear information about the policies and are transparent about their fees and services.
  1. Check contact details: Ensure the broker you’re dealing with has a legitimate physical address and official contact details. Be wary of brokers using only mobile numbers or free email services.

Scammers are experts at what they do, but these methods should be helpful if you ever encounter one. These points will help you identify and steer clear of ghost brokers, ensuring you deal with legitimate insurance providers.

Failure to Disclose Additional Drivers

As previously mentioned, insurance companies determine premiums based on the risk profile of all drivers. They do so by evaluating each driver’s driving history, age, and other factors that might affect the likelihood of an accident. Therefore, intentionally or otherwise, failing to disclose additional drivers has significant consequences.

If an undisclosed driver is involved in an accident, your insurer may refuse to cover the damages because you did not accurately represent the risk in the policy. Leaving you facing substantial out-of-pocket expenses. 

Moreover, if your insurer discovers that undeclared additional drivers have been consistently using the vehicle, they may cancel the policy altogether!

The simple truth is that omitting drivers from your policy can be considered insurance fraud.

In essence, full disclosure ensures your coverage is valid and comprehensive. It's a crucial step in maintaining the integrity and effectiveness of your car insurance policy.

Claim Stacking

Claim stacking is when you make multiple insurance claims for the same incident across different policies or insurance periods. The impact on insurance providers leads to them paying out more than the actual loss, increasing the overall cost of claims and affecting premium prices for all policyholders.

Claim stacking becomes fraudulent when you intend to receive compensation that exceeds the actual loss or damage. 

It also undermines the principle of indemnity in insurance, which aims to restore the insured to a client’s financial position before the loss, not to enable them to profit from their insurance.

Thankfully, insurance companies often have measures in place to detect and prevent claim stacking.

Plus, some policies might allow for a certain degree of claim stacking. However, you need to declare that you have policies with different companies. This could affect or delay the payout while the insurers decide which company is liable for the payment.

You must decide whether multiple policies with different insurers for the same asset is a stroke of genius or a waste of money.

Failure to Report Accidents

Insurance companies need accurate and timely information to assess the situation, determine liability, and process claims efficiently when an accident occurs. So, any failure to report an accident promptly delays all these processes.

Insurance policies stipulate that policyholders must report accidents within a specific period. 

Missing this window can lead to your insurer denying your claim and refusing to cover the damages, leaving you financially responsible for all repair costs and liabilities. 

Insurers often reject claims that fall outside the stipulated period due to several key reasons:

  1. Delayed reporting makes it harder for insurers to verify the accident's facts accurately.
  1. There's a higher risk of individuals fabricating or altering claims long after an alleged incident.
  1. Increased cost: If you don't promptly repair minor damage and it worsens over time, the cost of your claim could increase significantly.

In other cases, failing to report an accident can be considered a breach of your insurance contract. Naturally, this could lead to policy cancellation or non-renewal, making it more difficult and expensive to get insurance in the future.

Do the Crime. Pay the Fine. 

You may have claimed to be severely injured, so much so that you couldn’t work. And yet there you are on our timelines doing handstands at the bar. My friend, you’ve just been caught in 4K lying to your insurance provider and your boss.

Don't be caught out on the wrong side of the law. 

Insurers will conduct thorough research as part of their investigation process to ensure all aspects of a claim are accurate and legitimate. Questionable social media posts on platforms like Facebook or Instagram could inadvertently cast doubt on a claim. 

In the worst-case scenario, your insurance can deem this behaviour as fraud, reject your claim and even cancel your policy.

Remember, being honest and consistent in your insurance dealings is the best policy legally. It is also the safest approach in today's digitally connected world.

Conclusion

We've just successfully navigated the not-so-murky waters of insurance fraud (be honest, you probably already knew some of these were big no-nos).

If you ever feel tempted to be dishonest, even by a small margin, remember this: playing fast and loose with the truth, like exaggerating damages or conveniently omitting extra drivers, might seem harmless but can land you in piping hot water.

Embellishing up your application with a few 'white lies', 'forgetting' to mention those fancy new car mods or straight-up cutting corners in insurance isn't just risky—it's fraudulent.

In insurance, honesty isn't just about staying out of trouble; it's about ensuring your safety net is there when needed. So, if you've been playing a bit of a ‘catch-me-if-you-can’ with your insurance, it's time to straighten up. 

The truth always has a way of coming out.

One Last Thing

Hey, you. Yes, you. Why keep this tasty tidbit all to yourself when you can share it with the masses?

Spread the word and share this blog on all social media platforms so that others can learn all about sneaky insurance fraud.

And if you have your own story to tell or maybe have an inside scoop on a friend of a friend, we’d like to hear that, too. Our socials are linked here: X, IG, TikTok and YouTube.

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Resources on ethical insurance practices:

  1. The South African Insurance Association (“SAIA”) 
  2. The Insurance Crime Bureau

Pineapple (FSP 48650), is underwritten by Old Mutual Insure, a licensed FSP and non-life insurer. T&C’s apply. Premium is risk profile dependent.

Please Note: The information provided above is for informational purposes only; you should not construe any such information as legal or financial advice.

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