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Detected insurance frauds in 2018

Average insurance fraud now tops £12,000 with 1,300 insurance scams uncovered every day.

  • Average insurance scam uncovered is now £12,000, but a fraudulent claim for £1.2 million exposed.
  • The number of detected insurance application and claim frauds up – 1,300 exposed every day.
  • Two fraudsters every week convicted of insurance fraud.

The lengths insurance cheats will go to try to con their insurer are laid bare today (28 August) as the ABI publishes its annual detected fraud figures. The total number of fraudulent claims and applications detected in 2018, at 469,000, rose by 3% on 2017, with their value up 6%. Every day, 1,300 insurance scams are uncovered, with the average con of £12,000. A preacher, a rock guitarist pensioner, and an award-winning hotelier were among the insurance cheats exposed.

During the last year, the equivalent of two cheats every week received a criminal conviction or a caution for insurance fraud. Cases investigated by the Insurance Fraud Enforcement Department, the specialist police insurance fraud investigation unit funded by the insurance industry, included sixteen people involved in a crash for cash crime gang who received a collective 33 years in jail sentences, and a man convicted of selling fake motor insurance who was jailed for two years.

Some insurance cons uncovered over the past year include:

Nothing staged about crash for cash gang’s sentences. The ringleader of an organised gang that staged motor crashes to con nearly £1.2 million from insurers was jailed for six years. Other gang members also received jail sentences totalling nearly 33 years.

Burst pipe gang get a soaking. A criminal gang made fake claims of nearly £1 million for damage and lost earnings from restaurants they said had been flooded by burst water pipes. It turned out that they had deliberately smashed the water pipes and that the restaurants had never been open for business. The five men were jailed for a total of 14 years.

Ghost broker gets a real sentence. A man who sold fake motor fleet insurance policies to cover 70 vehicles was jailed for two years.

Praying for a payout. A preacher, and self-styled bishop, was jailed for 10 months when found guilty of staging a motor crash. He fraudulently bought motor insurance using another person’s details, then contacted the insurer saying he had crashed the car into another vehicle. It turned out that he owned the vehicle he said he had crashed into, and that the car he said he had been driving was in the church car park at the time.

No room for dishonesty. An award-winning hotelier was caught out claiming £34,000 in disability income from his insurer saying that his depression and anxiety meant he could not work, when he was in fact running a hotel.  He received a 14-month suspended prison sentence.  

A jail sentence is no holiday. A man made multiple claims to different travel insurers claiming that illness meant he had to cancel his family holiday. He used fake airline tickets, bank statements and emails of hotel reservations to claim nearly £20,000. He received a 16-month jail sentence.

Crate expectations of compensation. Earlier this year, a woman who staged a fall over a crate in a supermarket in West Yorkshire to claim compensation, received a 21-month suspended jail sentence.

It’s only rock and roll. A retired fridge engineer dropped his claim for hearing loss caused by his work, when it emerged that he was a frontman in a rock ’n’ roll band. Claim documents denied that he had any noisy hobbies. The judges gave the insurer permission to bring a case for contempt of court.

The ABI’s latest detected fraud figures show that in 2018:

  • A total of 469,000 insurance frauds were detected by insurers. Of these, 98,000 were fraudulent claims, with 371,000 dishonest insurance applications. The number of fraudulent claims detected fell 6% on 2017, while the number of dishonest applications for cover rose by 5%.
  • The value of the 98,000 dishonest claims detected, at £1.2 billion, fell marginally by under 1% on the previous year.
  • Motor insurance scams remained the most common and most expensive, with 55,000 dishonest claims worth £629 million detected. The number and value of these claims both fell on the previous year - down 8% and 9% respectively.
  • Of the 55,000 motor insurance frauds, 80% involved personal injury fraud. These ranged from staged crash for cash frauds to opportunistic scams. The measures in the Civil Liability Act will help ensure fair compensation for genuine claimants.
  • There were 20,000 property frauds detected, down slightly on the previous year. However, the value of these frauds, at £115 million, rose by 11%.

Mark Allen, ABI’s Manager, Fraud and Financial Crime, said:

“Insurance fraud is the scourge of honest insurance customers who make genuine claims. Insurance cheats can be ingenious, and are constantly looking for new scams to exploit, which is why the industry makes no apology for spending around £250 million a year on measures to tackle this crime. Spearheaded by the Insurance Fraud Bureau and the Insurance Fraud Enforcement Department, there will be no let-up in the industry’s determination to root out fraudsters and press for the stiffest possible penalties for these cheats.”

Ben Fletcher, Director of the Insurance Fraud Bureau (IFB), said:

“Today’s announcement by the ABI shows that organised motor fraud is still a big problem and one that the insurance industry, working together with the police, will continue to tackle.  Fraudsters are constantly reinventing themselves and application fraud and liability are areas of growth that we now need to focus on. It’s also important that members of the public continue to report suspected fraudsters anonymously through our Cheatline service, which is a valuable tool for disrupting fraudsters.”

Detective Chief Inspector Andrew Fyfe, Head of the Insurance Fraud Enforcement Department, said:

“The actions of insurance fraudsters increases premiums for honest customers and costs the insurance industry millions of pounds a year. Not only that, certain tactics used by these fraudsters, such as crash for cash claims, can put the lives of innocent members of the public at risk. For this reason, IFED continues to come down hard on insurance fraudsters; achieving convictions and other sanctions against these criminals on a weekly basis.
“Whilst we are pleased more and more fraudsters are behind bars, we will not be resting on our laurels. We will continue our dedicated work, alongside our partners in the insurance industry, to find those committing fraud and put them before the courts to ensure justice is done.”

-ENDS-

 

Notes for Editors

Enquiries to:

Malcolm Tarling                        020 7216 7410    Mobile: 07776 147667

Sarah Cordey                           020 7216 7375    Mobile: 07860 189071

Dominic Stannard                     020 7216 7350    Mobile: 07725 245838

 

  1. These latest detected fraud figures reflect some changes in methodology to the calculation of the volume and value of frauds, with figures restated where necessary. They provide the most accurate data available on the scope of detected insurance fraud.
  2. The Association of British Insurers is the voice of the UK’s world leading insurance and long-term savings industry. A productive, inclusive and thriving sector, we are an industry that provides peace of mind to households and businesses across the UK and powers the growth of local and regional economies by enabling trade, risk taking, investment and innovation.
  3. An ISDN line is available for broadcast
  4. More news and information from the ABI is available on our web site, abi.org.uk.
  5. Insurance fraud: ABI definition

ABI annual detected insurance fraud statistics

The ABI collects information annually regarding detected fraud to provide its members and wider stakeholders with an indication of the extent of detected fraud that the industry faces at both the application and claims stage. In turn, individual insurers have their own mechanisms for understanding their own exposure to fraud and taking steps to mitigate the related risks.

Reporting on and measuring all cases of fraud encountered by insurers presents some challenges. Insurers are able to report on and measure cases of clear detected fraud; that is where evidence of fraud is compelling. However, where an insurer has prevented an individual from obtaining insurance cover by way of, for example, its automated system-based fraud defences, or a claim is no longer pursued due to an insurer probing the circumstances of a loss, such scenarios are not always clear instances of detected fraud. 

Insurers would positively welcome increasing the numbers of convictions for insurance fraud.  However, despite significant investment from the insurance industry in the Insurance Fraud Enforcement Department (IFED) within the City of London Police, there is insufficient current police resource available to respond to and manage the number of cases of suspected fraud for investigation and enforcement. This has been compounded by regional police forces over recent years reducing their resources allocated to fraud and financial crime and having no objectives to devote resources to such criminality. As such, actual criminal convictions clearly only represent the tip of the iceberg, and are not a true reflection of the level of fraud that the insurance industry and wider society faces on a daily basis.

Accordingly, the ABI has developed a list of scenarios in which it is believed fraud is likely to be involved and asks its members to provide the numbers of cases which fall into those categories.  While some of those cases may have an innocent explanation, many more cases of successful fraud go undetected, especially for whiplash.  

The ABI’s fraud statistics are therefore intended to provide an indication of the volume and value of fraud detected by the industry. These statistics do not include claims which involve exaggerated personal injury, particularly for whiplash, where the claim has been paid.

The ABI seeks information from its members which fall into the following description, which has been based around the Fraud Act 2006, and reflects the definition adopted in relation to the Insurance Fraud Register:

Any party seeking to obtain a benefit under the terms of any insurance-related product, service or activity can be shown, on a balance of probabilities, through its actions, to have made or attempted to make a gain or induced or attempted to induce a loss by intentionally and dishonestly:

  • making a false representation; and/or 
  • failing to disclose information; and/or 
  • having abused the relevant party's position

And one or more of the following outcomes has taken place which relates to the fraudulent act:

  • an insurance policy application has been refused; 
  • an insurance policy or contract has been voided, terminated or cancelled;
  • a claim under an insurance policy has been repudiated;
  • a successful prosecution for fraud, the tort of deceit or contempt of court has been brought; 
  • The relevant party has formally accepted his/her guilt in relation to the fraudulent act in question including, but not limited to, accepting a police caution;
  • an insurer has terminated a contract or a non-contracted relationship / recognition with a supplier or provider;
  • an insurer has attempted to stop/recover or refused a payment(s) made in relation to a transaction;
  • an insurer has challenged or demonstrated that a change to standing policy data was made without the relevant customer's authority;

Provided that the relevant party has been notified that its claim has been repudiated, or relevant policy or contract voided, terminated, or cancelled, for reasons of fraud and/or it is in breach of the relevant terms and conditions relating to fraud within the relevant policy or contract.

The ABI also collects from its members’ information relating to cases of suspected insurance fraud:

Definition

Suspected fraud shall be considered to be present where there are reasonable grounds to believe on the balance of probabilities that any party seeking to obtain, or having obtained a benefit under the terms of any insurance-related product, service or activity can be shown, through its actions, to have made or attempted to make a gain, or induced or attempted to induce a loss by intentionally and dishonestly:

1.    making a false representation; and/or

2.    failing to disclose information; and/or

3.    having abused the relevant party’s position.

Scenarios

Where a handler having an actual suspicion of fraud (e.g. manual fraud indicator(s), tip off, system generated "high risk" referral etc) challenges the applicant/claimant by letter, telephone call or instruction of an investigator etc, to clarify key information, provide additional information or documentation etc, and the applicant/claimant subsequently:

  • formally withdraws the application/claim (by phone, e-mail or letter) without a credible explanation; or
  • accepts (without a credible explanation) either a substantially reduced settlement offer in respect of a claim, or a substantially increased premium in respect of an application/renewal (other than in cases where there has been a careless misrepresentation); or
  • fails to provide further documentation or co-operation; or
  • allows all communication with the insurer to lapse despite the insurer’s reasonable attempts to re-establish contact.

All other gone away claims/applications arising in the course of normal (i.e. non- exceptional) handling do not represent suspected fraud under this definition. These would include (but not necessarily be limited to):

  • gone away/withdrawn claims or applications when no preceding combination of suspicion and subsequent challenge has occurred.
  • gone away/withdrawn claims or applications where a "challenge" is applied to all new claims/applications of a particular class (e.g. Household accidental damage) as a matter of routine.
  • lapsed quotes, where no formal application for insurance cover has been made.

Last updated 28/08/2019